OhioHealth changed benefit administrators effective January 1, 2009 from Central Benefits to Humana, however, the network for the OhioHealth Associate plan continues to be the HealthReach Preferred network and reimbursement for OhioHealth services rendered to the insured will be at the HealthReach Preferred reimbursement rates.
The ID card and associated payment process with Humana is unique. Because of this we’d like to offer suggestions/instructions on how to get paid in the most efficient way possible for services rendered to the OhioHealth insured.
The ID card is also a debit card. This card contains valuable patient and claims processing information. Therefore, we recommend you make a copy of the front and back of this ID/debit card. We also recommend that you have the OhioHealth insured provide a signed “Easy-pay Consent” form. This form is available at www.humana.com. This consent form authorizes you to process the debit card as a credit card at the appropriate time to receive payment.
- Once services are rendered the following process will occur:
- The practice submits the claim to Humana
- Humana will pay the provider portion of the claim if a covered service is rendered and send a remittance advice reflecting the allowed amount, the amount paid and the patient’s responsibility.
- Upon receipt of the remittance advise, the practice can use the ID/debit card to receive payment by:
- Submitting the Visa number and expiration date from the ID card using your credit card terminal.
- If approved, payment will take place.
- If denied, bill the member for the patient’s responsibility.
If you have any questions please contact Humana at 1-877-230-3307.