Electronic Remittance Advice (835) and Electronic Funds Transfer Request Forms With the move to being Health Insurance Portability Assurance Act (HIPAA) compliant, Humana has made available the HIPAA X12N 835 version 4010 A1 electronic remittance advice (ERA). The electronic format may be accessed in the following ways:

Explore the Provider Self-Service Center

The online remit inquiry is a self-service application that enables providers to view remittance information online via the secured provider section of Humana.com. The function offers several different inquiry methods and the ability to customize the viewing of the data with the use of filters and sorts. Providers can also download the HIPAA X12N 835 version 4010 A1 electronic remittance advice remittance in a format (text or Word document) or as a remittance inquiry supplement file (Excel spreadsheet)

If you are not a current user of the secured provider section, please register.

Once you have access to the secured provider section of Humana.com, you can immediately access the online remit inquiry function to inquire about paid claims.

The Electronic Remittance Advice (ERA) offers a more automated process for providers who can accept auto posting transactions through a vendor, billing agency or clearinghouse. Humana utilizes Availity as the central gateway for delivery of 835 transactions. Upon enrollment, the ERA will replace the paper version of the explanation of remittance (EOR).

ERA/EFT FAQ Frequently asked questions and answers for Humana ERA/EFT. (29 KB) - Download PDF English New Enrollment ERA This form should be used when signing up for EFT. This form must be faxed with the ERA enrollment form as Humana only offers EFT with ERA. (290 KB) - Download PDF English EFT (113 KB) - Download PDF English

Vendor Change This form should be used when changing the vendor for an existing ERA setup. (119 KB) - Download PDF English Bank Change This form should be used when changing the bank account information on an existing ERA/EFT setup. (112 KB) - Download PDF English Cancellation This form should be used when canceling a ERA or ERA/EFT setup. (170 KB) - Download PDF English

Remittance Advise Remark Codes (RARCs)

HIPAA has mandated that the ANSI X12N 835 Health Care Claim Payment/Advice include Remittance Advise Remark Codes (RARCs). RARCs provide greater clarity of how claims have been adjudicated by adding a subset of descriptions to the generic, high level, Claims Adjustment Reason Codes (CARCs). Humana has revised its mapping of our proprietary coding that correlates to the mandated RARCs. Humana has assigned multiple RARCs to a CARC so that providers receive more adjudication detail concerning their claims. Humana has completed its mapping and is generating RARCs beginning July 13, 2008.

The RARCs appear in the LQ02 segment in Loop 2110 of the X12N 835. The LQ loop will not be created if Humana's proprietary codes do not have a HIPAA RARC associated to them. The LQ01 segment will contain the HE qualifier.