> ## Documentation Index
> Fetch the complete documentation index at: https://mso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Humana

> Humana profile: Medicare Advantage concentration, CenterWell care delivery, Availity transactions, and the MA appeals track.

**Humana** is distinctive for its **Medicare Advantage concentration** — MA is the core of its business rather than an adjacent line. It also operates **CenterWell**, a care delivery arm. For most practices, engaging with Humana means engaging with Medicare Advantage operations.

**Payer content ages fastest of anything on this site.** Portals move, forms change, payer IDs get reassigned, and **timely filing limits are contract-specific regardless of what any table says**. Treat this page as orientation; the payer's own current documentation and **your executed contract** are authoritative. **Checked August 2026.**

## Who they are

|                       |                                                                            |
| --------------------- | -------------------------------------------------------------------------- |
| **Parent**            | Humana Inc.                                                                |
| **Related entities**  | CenterWell (care delivery, pharmacy)                                       |
| **Lines of business** | **Medicare Advantage (the core)**, Medicaid, some commercial and specialty |

## Plan types on the card

Humana Gold Plus (HMO), Humana Choice (PPO), and other Medicare Advantage products; dual eligible special needs plans; Medicaid in some states; and a smaller commercial book.

## Enrollment and credentialing

Start at **[humana.com/provider](https://www.humana.com/provider)**. Many transactions run through **Availity**. Credentialing generally pulls from CAQH.

## EDI, ERA, and EFT

Standard three-part enrollment.

## Appeals

**Medicare Advantage appeals follow the federal MA appeals track**, not a commercial process. The levels, deadlines, and independent review mechanisms differ from commercial appeals — and MA plans are **not** bound by Medicare fee-for-service's 12-month timely filing limit. Their filing limits are contractual and frequently much shorter.

See [Medicare Advantage](/reference/payers/profiles/medicare-advantage).

## Quirks worth knowing

* **Prior authorization requirements are extensive** on MA products — this is one of the more auth-heavy payers
* **Risk adjustment and documentation** matter more here than with most commercial payers, given the MA model
* **CenterWell** operates as a care delivery competitor in some markets


## Related topics

- [The US payer landscape](/concepts/payments/the-payer-landscape.md)
- [Payers vs insurance companies (they're not synonyms)](/concepts/payments/payers-vs-insurance-companies.md)
- [Enroll and contract with commercial payers](/guides/enrollment/enroll-with-commercial-payers.md)
- [Set up EDI, ERA, and EFT with each payer](/guides/enrollment/set-up-edi-era-eft.md)
- [File appeals](/guides/billing/file-appeals.md)
- [How to use the payer reference](/reference/payers/overview.md)
- [Payer enrollment & submission links](/reference/payers/enrollment-links.md)
- [Timely filing limits by payer](/reference/payers/timely-filing-limits.md)