Humana Inc. Implementation Resources
myNEXUS is proud to announce its partnership with Humana, Inc. to provide utilization management for home health services.
myNEXUS is currently partnered with Humana to provide utilization management services in GA, OK, SC, and TX. To view program announcements for each state, please click here.
GA and SC: Please register for an orientation regarding the upcoming September 1st, 2019 delegation by clicking this link.
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.
Humana In-Scope Plans
Initial Authorization Request Form
Re-Authorization Request Form
Episodic Authorization Request Form
Provider Authorization Portal