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.

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

Medicare 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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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.

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.

Learn more

Request for External Review by an Independent Review Organization
Instructions | View form

HIPAA Authorization for Release of Information
Instructions | View form

Disclosure for Conflicts of Interest Evaluation
Instructions | View form