Provider self-service

Provider self-service offers many features that will save you time, ensure patient privacy and help manage your office more efficiently. It is simple, secure and available 24 hours a day, seven days a week for registered providers.

With provider self-service, you can quickly and easily:

  • Submit claims
  • Verify patient eligibility/benefits/claims
  • Check claim status
  • View remittances
  • Create and update referral and authorization requests
  • Manage your profile
  • Look up codes
  • Send and receive chats and secure messages

Register for self-service now

If you need assistance with registering, logging in, resetting a password, verifying eligibility or another task, check out our guide to provider self-service to learn how to take advantage of this secure tool. Enrolling to access provider self-service features requires your 9-digit tax ID or 9 digit EIN with the correlating NPI# as secondary validation.

Major features include:

TRICARE patient profile

  • Up to five eligibility checks at a time — in real time
  • Cost-share/copay info
  • Program information
  • Beneficiary eligibility history
  • Other Health Insurance (OHI) information
  • Referral by patient status
  • Claims by patient status

Code lookup

  • Access CPT and diagnosis code lookup about covered procedures and services with messaging that assist in determining referral or authorization needs:
    • Limitations and exclusions
    • Exempt from Prime referrals
    • Noncovered service

Referrals and authorizations

  • Build referral/authorization request
  • Updating existing referrals and authorizations
  • Adding visits and services to referrals
  • Updating admission and discharge dates for inpatient hospital stays
  • Extending the coverage period
  • Adding procedure codes (Most types of service have procedures already identified)
  • Accessing code lookup messages about procedures and diagnoses, shown in red (for example, “no referral required” or “noncovered service”)
  • Selecting a provider
  • Entering up to five lines of pertinent clinical information that will be transmitted to the referred-to provider
  • Many approvals and updates display immediately, saving you time
  • Attach x-rays, pictures and notes where needed

TRICARE provider profile

  • Network provider view and update requests by locations
  • Professional provider credentialing status
  • PCM panel count and listing to include patient detail on referrals, HEDIS alerts and pharmacy
  • Network provider types of service by location
  • Professional provider count and listing by location

Claims

  • Check status of existing claims
  • Line-level details provided
  • View and print remittances
  • View and print letters
  • View notifications
  • Submit new claims

Other provider services

  • Provider chat
  • Claims status by patient
  • User profile and update options

Gaining access to provider self-service

When registering for provider self-service, providers have four different options for gaining access:

  • Site administrator express code: Providers may use an express code from a local site administrator responsible for the provider ID they want to access.
  • Existing referral information: Providers may enter the authorization/order number and key code shown on a received Humana Military—TRICARE Referral/Authorization fax. The provider ID they are requesting access for must be associated with the authorization/order number entered.
  • On-site Humana Military provider representative validation: The provider representative must enter several key codes to grant a provider immediate access to provider self-service.
  • Manual approval: If the previous options are unavailable, providers may submit an approval request to a local site administrator (usually a person who works for the provider) for the provider ID they want to access. If a local site administrator does not exist, a Humana Military provider representative will review the request and confirm or deny the right to obtain access.

Trusted site information

If you are concerned about misuse of internet access in your office, you can always designate HumanaMilitary.com as a trusted site. A trusted site is a website that you trust not to damage your computer. If the security level of your Internet Explorer browser is high, you may be unable to access a specific website that you trust. To access the website, add the URL to your trusted sites list or change your security level to medium or lower. When using a high security level, you need to add the web application URLs to your trusted sites list.

To add a trusted site in Internet Explorer, follow these steps:

  • In the Internet Explorer tools menu, click internet options.
  • On the security tab, click trusted sites.
  • In the security level for this zone box, you may need to do one of the following:
    • If it is set to high, use the slider to change it to a lower security level.
    • If it is set to custom, click default level and use the slider to change the security level.

Note: If you are running Windows Vista, verify that enable-protected mode is not selected.

  • Click the sites button.
  • In the field, add this website to the zone, type the URL for the trusted website.
  • Deselect require server verification for all sites in this zone and click close. In the internet options dialog box, click OK.

 Note: Mozilla Firefox does not specifically offer a trusted sites setting. However, you can set allowed sites for the limited purpose of installing cookies and add-ons. From the tools menu, select options and go to the security tab.

Humana Military resources