Credentialing by payer
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- Flat PricesNo percentage of collections
- Half Now, Half at SubmissionFor every enrollment application
- Closed Network?Your choice of a refund or a credit
- Live Status TrackingCheck any application by reference number
Humana at a Glance
| Service area | National Medicare Advantage; Humana Healthy Horizons Medicaid plans in individual states such as Ohio and Oklahoma; TRICARE East Region through Humana Military. |
|---|---|
| How to request to join | Solo practitioners and many groups complete Humana's online provider self-nomination form. Groups with several TINs or billing NPIs, hospitals, IPAs, PHOs and health systems go through a regional contracting representative. Start here |
| Portal | Availity Essentials |
| CAQH ProView (DataSpring) | Yes. Every practitioner must be registered with CAQH with current, accurate information before credentialing. |
| Lines of business | Medicare Advantage, Medicaid (Humana Healthy Horizons, which requires state Medicaid enrollment first), and TRICARE East through Humana Military, which needs its own contract. |
How Humana Takes Applications
Humana treats contracting and credentialing as separate tracks. The self-nomination form expresses interest and starts contracting; credentialing draws on the CAQH (DataSpring) profile. In Humana Healthy Horizons markets such as Oklahoma, credentialing applications are completed in Availity Essentials, and Availity makes up to three email attempts to collect anything missing.
What to Watch With Humana
Humana Military is a different network. TRICARE certification only makes a provider TRICARE-authorized non-network; East Region network status takes a contract with Humana Military, and paper certification applications take about 90 days. In Oklahoma, a provider already credentialed for Humana Medicare still needs a current CAQH or Availity application for the Medicaid review.
Whatever the plan, the file moves only when your CAQH (DataSpring) profile, license record and application agree. See how long credentialing takes and our CAQH profile setup service.
Questions About Humana
How do I apply to Humana?
Solo practitioners and many groups complete Humana's online provider self-nomination form. Groups with several TINs or billing NPIs, hospitals, IPAs, PHOs and health systems go through a regional contracting representative.
How long does Humana credentialing take?
Humana does not publish a turnaround on the provider pages we checked; most commercial plans land between 90 and 120 days from a complete file.
Does Humana use CAQH (DataSpring)?
Yes. Every practitioner must be registered with CAQH with current, accurate information before credentialing.
What does PECS charge for a Humana application?
$200 per application per provider, half at engagement and half at submission, including follow-up with Humana until the effective date is set.
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Sources
- Humana: Join our network
- Humana: Join our network flyer (self-nomination)
- Humana Healthy Horizons in Oklahoma: Credentialing resource guide
- Humana Military: Provider certification FAQ
Facts checked against the sources above in October 2026; plan procedures change.