Nov 18 2821 08:13:34 Via Fax > VoxPax ATAT / Hunana Page 881 Of 884 Humana Facsimile Transmission Attention: " Company: Fax Number: 9549670109 Sender: Emmanuel Amat Sender Phone: Sender Fax: 15132976536 Fax Notes: Attn. to. Hector Please do not respond to or send faxes to this fax number as all faxes must be sent to (888) 566-2128 for proper handling. Thank you. The information transmitted is intended only for the person or entity to which it is addressed and may contain CONFIDENTIAL material._If you receive this material/information in error, please contact the sender and delete or destroy the material/information. Humana Inc. and its subsidiaries comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, ancestry, age, disability, sex, marital status, gender, sexual orientation, gender identity, or religion. 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Zadzwor pod numer 1-877-320-1235 (TTY: 711) ‘BS (Korean): FEI: HAS ASSES SH, AO Ala MAS FRE O18 Stal + SSUCH 1-877-920-1235 (ITY: 711) HO HSH FUALS Date and time of transmission: 11/10/21 - 08:13:11 AM Number of pages including this cover sheet: 4 It this transmission is not received in good order, please call Sender's Phone # or advise by fax Sender's Fax # The information transmitted is intended only for the person or entity to which itis addressed and contain CONFIDENTIAL material. If you receive this materialinformation in error, please contact the sender and delete or destroy the materialinformation.VoxPax ATAT / Hunana Page 883 Of 884 Humana. {ington He 40512-4601 10/19/2021 Cardiovascular Consultants 7421 N University Dr Ste 112 Tamarac, FL 33321-2952 Patient Name: SONIA BARIAN! Patient Date of Birth: 09/25/1956 Member ID Number: 74220054 Group Number: 8530011 Humana Entity Humana Medical Plan, tne. Claim Number(s): 820202840161538 Service Date(s): 01/16/2020 Account Number: 76165212545 Reference ID: 021285923045 Provider: Cardiovascular Consultants Dear Cardiovascular Consultants: Thank you for contacting Humana with your request. We reviewed the information surrounding your request received on 10/11/2021. After thoroughly evaluating all of the available information, we have completed a review of your concern regarding the payment of this claim/these claims and we have maintained our original benefit determination(s). Payment is not allowed for this claim because it was submitted after timely filing limitations. Proof of timely filing can be sent to the claims address on the back of the member's ID card for claim reconsideration. You can contact us at the toll-free number on your patient’s Humana identification card with questions or concerns about this or future claims. If you use a TTY, please call 711, Our customer care representatives are available Monday through Friday from 8 a.m. to 8 p.m. Eastern time, or you can. write to us at Humana Claims Department, P.O. Box 14601, Lexington, KY 40512-4601. For your convenience, we have online tools to make it easier for you to do business with Humana, You ‘can check eligibility and benefits for Humana-covered patients, manage claims, conduct referral inquiries, request authorizations, and view fee schedules and other information through the secure multipayer website Availity.com.VoxPax ATAT / Hunana Page B84 Of 884 To register and use these tools, please go to the secure Availity portal at Availity.com and select "Register" to sign up. For technical website issues, contact Availity Client Services at 1-BOOAVAILITY (1- 800-282-4548), Thank you for your assistance and continued care of your Humana-covered patients. Sincerely, Correspondence Representative