Improved Access to Claim Information Available in My Account

HMSA’s My Account offers a better way to view your in-state claims information for most plans.

Not all of our HMSA plans have this functionality. If you need your claims information and are unable to find it in My Account, please contact HMSA Customer Relations.

The Web tool allows you to:

  • See a summary of your medical and vision services sorted by date of service.
  • Sort claims by date of service, provider, status, and the amount you may owe.
  • Search for specific claims.
  • See whether claims are “processed” or “in process.”

To view the claims tool in your My Account:

  • Register and log on to My Account. Each plan member age 18 and older must create their own My Account.
  • Click on the Claims tab at the top left corner of the page or on View Claims at the right side of the page.
  • Plan subscribers are able to view claims for dependents under the age of 18 by using the Show Claims For drop-down menu. Spouses will only have access to their own claims.
    • For example, Mary (a plan subscriber) may view her daughter’s claims but her husband, John, (who is listed as a spouse on Mary’s plan) will only be able to view his claim information through his My Account.

Claims labeled “in process” won’t have detailed information, but will let you know the claim has been received.

Clicking on each claim will display the following details about how your services are paid:

  • Total charge: The amount your provider billed for the service.
  • HMSA discount: The amount HMSA has negotiated with a provider on your behalf. Applied only when you use a participating HMSA provider.
  • Eligible charge: The total amount eligible for payment to a participating provider.
  • HMSA paid: The amount HMSA paid you or your provider.
  • You may owe: The amount you may owe the provider.
  • Claim messages: If available, click on the More Info tab listed next to services to view additional messages. These include an explanation about why a service was denied.

If applicable, the detail screen may provide other information, such as the amount applied toward your plan’s annual deductible or payments made by other insurers.

If you currently receive Report to Member (RTM) statements online, you’ll continue to receive your RTMs in your My Account. The tool includes convenient links to your RTMs.