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Single Case Agreement Humana

As a professional, I understand the importance of using relevant keywords to boost the visibility of an article. That`s why I have chosen the topic “single case agreement Humana” for this article. In this article, we will discuss what single case agreements are, how they work and what Humana offers in this regard.

Single Case Agreements: An Overview

Single case agreements (SCAs) are contracts between a healthcare provider and an insurer that cover the treatment cost of a patient who is not covered by the insurer`s network. This is usually the case when a patient needs specialized treatment that is not available within the insurer`s network. In such situations, the patient`s provider negotiates a single case agreement with the insurer to cover the cost of the out-of-network treatment.

SCAs are also known as “out-of-network agreements” and “gap-filling agreements.” They are typically negotiated between health care providers and insurance companies on a case-by-case basis. The terms of the agreement may vary depending on the specific situation.

How Single Case Agreements Work

When a patient requires specialized treatment that is not within the insurer`s network, the healthcare provider will contact the insurer to negotiate an SCA. The provider will provide the insurer with the patient`s medical history, treatment plan, and expected outcomes. The insurer will review the information and decide whether or not to approve the SCA.

If the insurer approves the SCA, the provider can proceed with the out-of-network treatment. The insurer will reimburse the provider for the treatment cost at a negotiated rate.

What Humana Offers in Terms of Single Case Agreements

Humana is one of the leading health insurance providers in the United States. They offer a variety of health insurance plans, including Medicare Advantage plans, individual and family plans, and employer-sponsored plans.

Humana`s single case agreements are designed to help patients access specialized care that is not within the company`s network. The company has a team of medical professionals who review each case and make a determination on the necessity of the requested treatment. The healthcare provider negotiates the terms of the SCA with Humana, including the treatment cost and reimbursement rate.


Single case agreements are an essential tool for patients who require specialized treatment that is not covered by their health insurance network. Humana offers single case agreements to help patients access the care they need. As a professional, I have used the relevant keywords to ensure that this article is visible to those seeking information on single case agreements and Humana`s services in this regard.

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