Humana
Overview
National commercial and Medicare Advantage health insurance payer. Customers submit provider rosters to Humana on recurring cadences; roster format and submission channel specifics vary by customer.
Active Work / Processes
- Monthly roster submissions — NFL Surgeons submits provider rosters to Humana monthly. Currently a manual process: addresses, licenses, and DEA numbers collapse into single cells in Medallion’s report-builder CSV export, requiring manual splitting before submission. Payer-roster product SKU may resolve (per Gong, 2026-04-20).
- Sub-delegation / CVO designation — Access Medical Clinic has an existing Humana delegated credentialing agreement; Humana sends the CMS preclusions list to the delegate entity. AMC needs to notify Humana to redesignate Medallion as their CVO/sub-delegate; conversations not yet started as of 2026-04-20 (per Gong, 2026-04-20).
- Delegated agreement — Revere Medical (AZ) — Revere Medical has a confirmed Humana delegated credentialing agreement for Arizona. Medallion generates delegation rosters; Revere reviews and forwards to Humana. Revere must notify Humana to designate Medallion as sub-delegate — Matt or Sarah Loro to reach out per 2026-04-20 check-in (per Gong, 2026-04-20).
Key Facts
- Monthly roster cadence confirmed for NFL Surgeons.
Related Customers
Source History
- 2026-04-20 — NFL Surgeons | Medallion Monthly Sync
- 2026-04-20 — Access Medical Clinic | Medallion: Bi-Weekly Implementation Sync
- 2026-04-20 — Check-In on VMD Providers (Revere Medical)