AvMed is transitioning to their Provider Portal to Availity. Availity will provide enhanced access and streamlined process over the prior provider site. AvMed will begin utilizing Availity for the below items effective 1/1/2026.

• Key updates include a new portal experience through Availity Essentials, allowing Providers to manage eligibility, benefits, and claims in one familiar, multi-payer platform, and transition to Zelis payments, offering improved transparency and easier access to payment and remittance information.

Please also note AvMed no longer offers Medicare Advantage lines of business.

CarePlus is transitioning the authorization process effective January 1, 2026.

• Authorizations will now be requested via Availity or by faxing clinicals to 520-448-3581 office 800-662-4781
• Case Management will now be handled by Humana's One Home team once authorization is approved. They can be reached at office 800-662-4781 and by fax 520-448-3581

Starting 2/1/2026 the One Home team will transition to the Anna portal where you can communicate the case management via the platform, and upload clinicals. Please note authorizations will still need to be requested via Availity.

Please note CarePlus members have been given new member ID's. You will have to call in to obtain the new numbers if you already had these members in house.

CarePlus Provider Playbook 2026

Reach out to our educational email for links to additional educational opportunities.

HealthSpring takes over Prior Authorizations January 1, 2026.

Cigna Healthcare's Medicare Advantage line of business has sold and transitioned to HealthSprings as a standalone product.

This means beginning January 1, 2026 providers will submit 2026 requests to HealthSpring via Availity's payer spaces. Please note the picture on payer spaces has now changed to read HealthSprings.

Humana has announced an important update impacting Skilled Nursing Facility (SNF) utilization management in Florida. Below is a summary of what providers need to know and how to prepare.

Effective February 1, 2026:

• OneHome, as a delegated entity of Humana, will assume responsibility for SNF Utilization Management (UM).
• Authorization submissions will continue through Availity™ — no change to the preservice authorization process.

What’s New:

• OneHome has partnered with Post Acute Analytics (PAA) to support SNF UM activities.
• PAA will utilize its Anna™ software platform to help monitor:
• Patient care processes
• Quality and outcomes
• Care transitions before, during, and after hospitalization

Humana One Home Notice