Where can I find a medical claim form
Thank you for reaching out to us today!
I have included a link below to access the claim form.
You can also locate a Health Benefits Claim Form at http://www.humana.com/members/tools/forms.asp (copy and paste link in a browser)
To submit a claim for services rendered, you may submit an itemized bill from the provider of service or a completed Health Benefits Claim Form. If you do not have an itemized bill or receipt, you can request one from your provider's billing office.
The itemized bill or receipt must include all of the following:
*Valid diagnosis code (s)
*Valid procedure code (s)
*Amounts charged per procedure code
*Provider’s federal tax identification number
To send in the claim:
Verify the member identification number, patient name, and date of birth is recorded on the itemized bill or receipt. If not, write it on the bill or enclose a copy of your insurance card.
Make a copy of the bill for your records.
Send the original to: Humana Claims Office
P. O. Box 14601
Lexington, KY XXX-XX-XXXX
Note: Once you've mailed your claim request to the address above, please allow up to 30 days for your claim to be received and processed.
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