How to Submit a Superbill to Humana for Therapy Reimbursement

Humana Out-of-Network Process

Humana members submit OON claims through the MyHumana member portal at humana.com or by mailing a paper claim to the OON claims address printed on their insurance card. Members must complete a Humana claim form and attach the original superbill. Humana processes behavioral health OON claims through a separate department from medical claims, so the mailing address may differ.

Common Denial Reasons

• ✗Behavioral health OON claim sent to the medical claims address instead of the behavioral health address
• ✗Provider's NPI not registered in NPPES or listed incorrectly
• ✗Claim exceeds the annual OON session limit under the plan
• ✗Diagnosis code does not qualify as a covered behavioral health condition under the specific Humana plan

Tips for Getting Reimbursed by Humana

• ✓Humana uses LifeSynch to administer some behavioral health benefits — clients should call the number on their card to confirm
• ✓Ask clients to request an OON benefits breakdown in writing from Humana before their first session
• ✓Humana's timely filing window is typically 365 days for OON claims — longer than most carriers
• ✓Medicare Advantage Humana plans have different OON rules than commercial plans — always clarify plan type