NH

Humana Behavioral Health Appeals in New Hampshire

Appealing a Humana behavioral health denial in New Hampshire means tracking two separate clocks: Humana's own 30-day Level-1 appeal window, and New Hampshire's 30-day prompt-payment statute (RSA § 420-J:6) for clean-claim payment (best-effort default — verify). This guide covers both, plus Humana's filing address and New Hampshire's parity protections.

Where to file your Humana appeal

Appeal Address
Humana Medical Appeals
P.O. Box 14601
Lexington, KY 40512
Level-1 Response Window

30 calendar days

External Review Deadline

60 days from Level-1 denial

Provider Portal
File online
Fax

1-800-832-4651

New Hampshire's prompt-payment window

This data is a best-effort default based on a general survey of state insurance codes. Verify the current statute and day count with New Hampshire's Department of Insurance before citing it in an appeal.

In New Hampshire, state-regulated (fully-insured) plans — including many Humana plans — generally must pay or formally respond to a clean claim within 30 calendar days under RSA § 420-J:6. This deadline does not bind self-funded ERISA plans. This is a claim-payment deadline, not the appeal-decision deadline. If Humana missed this window on your claim, cite it as a separate payment violation alongside your Humana appeal — not as the deadline for the appeal decision itself.

MHPAEA parity for Humana in New Hampshire

Federal MHPAEA (29 USC § 1185a; 29 CFR § 2590.712) applies to Humana's group health plans operating in New Hampshire. The CAA 2021 § 203 disclosure duty requires Humana to produce its NQTL comparative analysis on request.

Humana's parity posture: Federal MHPAEA parity does not apply to Humana Medicare Advantage plans — the parity argument on this page applies only to Humana commercial/ERISA plans. Humana administers behavioral health through an internal BH team. Strong Medicare Advantage presence — MA plans follow Medicare appeals rules (42 CFR § 422), which differ from commercial ERISA rules.

State-level parity laws may add further protections in New Hampshire — check with the state's Department of Insurance for current guidance.

Common Humana denial codes

The most common Humana denial codes for behavioral health are: CO-4, CO-97, CO-119. Each has a dedicated guide with the denial explanation and appeal strategy.

New Hampshire's insurance commissioner

If your internal Humana appeal is denied, New Hampshire's Department of Insurance can help with a complaint or external review for fully-insured plans. Look up the official contact via the NAIC consumer locator.

Note: self-funded ERISA plans are generally exempt from state insurance regulation. If your patient's Humana plan is employer-sponsored and self-funded, your remedies run through the U.S. Department of Labor (EBSA) rather than New Hampshire's commissioner.

Generate your Humana appeal letter

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Frequently asked questions

How long does Humana have to respond to an appeal in New Hampshire?

Humana generally has 30 calendar days to respond to a Level-1 appeal. If denied, you have 60 days to request external review. Separately, New Hampshire's prompt-payment statute gives payers 30 days to respond to a clean claim (RSA § 420-J:6) — a different deadline governing claim payment, not the appeal decision.

Does MHPAEA apply to Humana in New Hampshire?

Generally, yes — for Humana's group health plans. Federal MHPAEA (29 CFR § 2590.712) applies to Humana's group health plans in New Hampshire. Request Humana's NQTL comparative analysis under CAA 2021 § 203.

Where do I mail or fax a Humana appeal?

Mail to Humana Medical Appeals, P.O. Box 14601, Lexington, KY 40512. You can also fax to 1-800-832-4651. This address is the same nationally, including for New Hampshire providers.