Humana Medicare Advantage
Also covers / subsidiaries: Humana, Humana Gold Plus, Humana MA
Core Payer & Clearinghouse Profile
Electronic Payer ID
61101
61101 is Humana's primary professional/institutional claims payer ID (encounters use 61102). Some Humana MA plans route differently.
Timely Filing Limit (TFL)
Per provider contract; commonly up to 365 days from DOS. Verify against your contract
Appeal Window
Medicare Advantage appeals follow CMS Part C rules (commonly 60 days from the organization determination)
Clearinghouse Gateway
Availity (Humana's preferred provider portal/clearinghouse)
Provider Services
Varies — confirm via portal / clearinghouse
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
https://provider.humana.com/
One of the largest Medicare Advantage carriers nationwide. Verify the exact payer ID and windows against your agreement and the member's plan.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Humana Medicare Advantage.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under Humana Medicare Advantage.
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Cariten Healthcare | 61101 | Par | None | 837P837I835 ERA |
| Cariten Senior Health | 61101 | Par | None | 837P837I835 ERA |
| Group Health Insurance De | 61101 | Par | None | 837P837I835 ERA |
| Health Value Management - De (Humana) | 61101 | Par | None | 837P837I835 ERA |
| Hmpk, Inc. | 61101 | Par | None | 837P837I835 ERA |
| Humana | 10100 | Non-Par | None | 276/277 |
Resolution Tools for Humana Medicare Advantage Claims
Values vary by plan, line of business, and provider agreement. Confirm in the payer portal or with your clearinghouse gateway before submitting electronic claims.
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