AAH meets with Humana Military on documentation glitch

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Tuesday, July 16, 2019

WASHINGTON – AAHomecare has requested that Humana Military waive the requirement for documentation submission with each subsequent rental month after the initial documentation is received.

Humana Military, which manages the Tricare East contract, is currently evaluating the request, the association says.

The development comes after Laura Williard, vice president of payer relations, and David Chandler, director of payer relations, met with executive leadership at Humana Military and Wisconsin Physician Services, its claims processor.

AAHomecare says the problem stems from the WPS’s claims system not being able to connect documentation to claims.

“With the volume of documentation being received, the indexing of these items has been in a backlog situation and is creating inaccurate claims denials,” the association wrote in a bulletin.

Humana says it is aware of the issues and has made the following fixes: claims are being put into a suspended status instead of being denied; claims are automatically being checked for documentation each day and are paid when the documentation is available; and documentation indexing and claims processing have been combined.

Additionally, Humana expects to complete a project this month to bring indexing of medical documentation up to date.