myNEXUS | Humana Inc. Resources
myNEXUS is proud to announce its partnership with Humana, Inc. to provide utilization management for home health services.
myNEXUS has currently partnered with Humana to provide utilization management services in Georgia, Oklahoma, South Carolina, Texas, Ohio, Kentucky, Southern New Jersey, Pennsylvania, and West Virginia. Please find important announcements, documents, and forms listed below.
Agency Information Form:
Please complete the “Agency Information Form” to have your agency’s information added to the myNEXUS system. The form is found online here.
Authorization Program Materials:
In-Scope Plan List: The list of in-scope Humana plans for the myNEXUS delegation.
Fax Confirmation Form: Online form providers use to confirm their fax numbers for authorization requests.
myNEXUS utilizes Interqual to facilitate appropriate evaluation of medical necessity by including assessment of the member throughout the continuum of care. A synopsis of the criteria is available to Providers and Members on request and free of charge by calling myNEXUS at 1-833-845-8684 or by emailing provider_network@myNEXUScare.com
Please contact the myNEXUS provider network team with any questions at provider_network@myNEXUScare.com.