Medical Foster Care Billing and Claims Payment Guide

This guide provides detailed information on the billing and claims payment process for medical foster care (MFC) services under Humana Healthy Horizons. It outlines the strategy for contracting MFC services, emphasizing that Humana Healthy Horizons aims to minimize the administrative burden on MFC parents. Claims can be submitted using the CMS-1500 form or through Availity, with specific instructions for atypical providers. The document specifies the reimbursement rates for various levels of MFC services, which are aligned with Florida Medicaid fee schedules. It clarifies that no prior authorization is required for reimbursement and details the timeline for processing claims. Additionally, the guide includes contact information for inquiries related to MFC services, claims payment issues, and escalation processes. It also directs providers to access training materials and additional resources available on the Humana website.