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Appeals & Grievances

If you disagree with us on a claim decision or simply had a bad experience with us, we want to know about it.

Appeals

How to Appeal an HMSA Decision as a Commercial Member

An appeal is a formal way of asking HMSA to review a decision on a denied claim. Learn more about the process.

Appeal of an HMSA percertification decision
Expedited appeal

Featured articles

HMSA Medicare Advantage Member Appeals

You can ask us to recheck a decision about your health plan or prescription drug coverage for services or benefits you've received.

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QUEST Integration Member Grievances and Appeals

If you have questions, suggestions, or a grievance about HMSA QUEST Integration services, we can help you with most of your questions over the phone or send your inquiries in writing.

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Commercial Member Form to Appeal

You can ask us to recheck a decision about your health plan or prescription drug coverage for services or benefits you've received.

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Dental Appeals

You can ask us to recheck a decision about your health plan or prescription drug coverage for services or benefits you’ve received.

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Request for Insurance Commissioner External Review

You can ask to have an independent review organization look over your appeal if you think we made a mistake.

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