Humana
Humana is a payer organization. For an ASC, what matters isn't the logo. It's how Humana pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Humana analysis
Tell us where to send it. Our team will prepare an analysis of Humana covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Humana pays
See how Humana reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
See where Humana concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Humana and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Humana's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Humana up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Humana
- Payer ID
- 61101 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Humana through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Humana members are verified before the date of service, through a clearinghouse using payer ID 61101or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Humana directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Humana the way it pays.
- What is Humana's payer ID?
- Humana's electronic payer ID is 61101. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Humana through a clearinghouse.
- How do ASCs verify eligibility for Humana members?
- Eligibility and benefits for Humana members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 61101) or through the payer's provider portal.
- Does Humana require prior authorization for ASC procedures?
- Prior-authorization requirements for Humana are set per plan and per procedure. Confirm whether an authorization is required with Humana directly before the date of service.
- What type of payer is Humana?
- Humana is a payer organization.
- How does Humana compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Humana pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Humana paying my ASC below market?
- Put your own Humana contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.