Wiki HUMANA VS Well visits and immunizations


Best answers
Help, I have tried speaking with customer service and have now had to send a request to high up contacts. Has anyone noticed that Humana stopped paying for the Well visit when the patients have immunizations. They can give me no information on this. I've ran the codes and they do receive any bump back with the CCI edits. I cant say they need a modifier now because we had a patient that came for a follow up and received their flu shot so I did modify that and they still didn't pay for the visit. Please help our denials are starting to stack up.
We tried the claim edit simulator and modifier are not working. Does anyone else have any information that could help.
Humana Front End Edit Error

This was as front end coding edit error on Humana's end that began the first of December. All Preventative and E/M codes that were billed with a -25 modifier were being denied as bundled. I spoke with Humana on Tuesday and was informed the error was identified and corrected on 1/16/16 and all claims that were denied would be reprocessed which will take approximately 45 days to clear everything. These denials were happening to all providers. As of yesterday I began to see several of my denials reprocessing.