Coverage profile
How Substrate can help you with Humana
Substrate can help practices and billers with the following claims tasks for Humana.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Humana.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Humana.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Humana.
Phone claim status
Automated phone agentAppeals agent
AI appeals workflowThe Substrate Appeals Agent can submit appeals for RFIs, medical record requests, downcoding reconsiderations, and more via the payer portal for Humana.
Payer intelligence
Observed adjudication timing
How long completed claims in Substrate’s aggregate network took from payer receipt to the 835 payment date.
Median time to payment
5 days- 10% of adjudications by
- 4 days
- 90% of adjudications by
- 6 days
- Applicable state coverage
- KY
- Current As Of
- August 2026
Five-month median trend
Days to 835 paymentView chart data as a table
| Service month | Median | 10% of adjudications by | 90% of adjudications by | Completed claims | Coverage |
|---|---|---|---|---|---|
| Apr | 5 days | 3 days | 33.2 days | 1,383 | KY |
| May | 5 days | 3 days | 18.3 days | 4,268 | KY |
| Jun | 5 days | 4 days | 9 days | 5,207 | KY |
| Jul | 5 days | 3 days | 9 days | 4,571 | KY |
| Aug | 5 days | 4 days | 6 days | 705 | KY |
2027 maternity billing research
When does Humana change OB/GYN billing?
No public 2027 maternity billing start date found. Use current contract, product, and claims-edit instructions until Humana publishes a maternity-specific transition.
- Transition start
- Not published
- Billing start
- Not published
- Published
- Not stated in source
- Current As Of
- August 2026
Scope: Humana public claims-policy index; no maternity-specific 2027 policy
Claims payment policies. Verify the payer source before claim submission.
Frequently asked questions
Humana payer FAQs
How do I check claim status with Humana?
Providers check Humana via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Humana portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for Humana?
The primary payer ID for Humana is 61101. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for Humana?
The provider portal for Humana is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Humana?
The 837P and 837I payer ID for Humana is 61101 via Stedi.
What is the 835 payer ID for Humana?
The 835 payer ID for Humana is 61101 via Stedi.
What is the 270 payer ID for Humana?
The 270 payer ID for Humana is 61101 via Stedi.
What is the 276 payer ID for Humana?
The 276 payer IDs for Humana are 61101 via Stedi and 61101 via Availity.
Routing reference
Humana payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | HumanaSource: Substrate payer directory · last refreshed |
|---|---|
| 837P professional claims payer IDStedi | 61101Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 61101Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 61101Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 61101Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 61101Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | 61101Source: Availity payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Humana. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: HUMANA. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Humana. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
Humana phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Behavioral health phone
- (855) 364-0374OhioRISE
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(855) 364-0374 | Behavioral healthBenefit context: Other or Additional Payor |
| Mental Health |
Phone and fax numbers sourced directly from the payer response
Other aliases
Also known as
- 00041
- 10100
- 10353
- 11213
- 14325
- 2449
- 4544
- 61101
- 61101MA
- 61108
- 62073
- 65031
- 65031MA
- 73288
- XYMXQ
- Z96304
- Arcadian Management Services
- CareSource Kentucky
- CareSource Kentucky Marketplace
- CareSource Medicaid Kentucky
- CareSource Medicare Advantage Kentucky
- Careplus health plans
- Cariten Healthcare
- Cariten Senior Health
- Eagle Creek Medical Plaza
- Emphesys
- Emphesys Insurance Company
- Health Value Management
- Humana Careington
- Humana Choice