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Pharmacies Participating With HMSA's Medical Plans
 
Before Treating the Patient
 
Benefit Policies
 
Claims Filing
 
General Reference
 
Injectables and Infused Drugs
 
Participating With HMSA
 
Payment, Reports and Appeals
 
 
ALL HANDBOOK DOCUMENTS:
 
Document Name:Document Number:
Agent Authorizationpel.aa.AGE.500
Benefit Overpaymentpel.aa.BEN.500
Billing for BMIpel.aa.BIL.201
Billing for DMEpel.aa.BIL.200
Billing for Injectable Drugs (Non-Vaccines)pel.aa.BIL.350
Billing for Senior Planspel.mp.BIL.800
BlueCard Programpel.aa.BLU.500
CMS 1500 Claim Form - General Instructionspel.aa.CMS.400
CMS 1500 Claim Form - Vendorspel.aa.CMS.600
Coordination of Benefits - HMSA and Medicarepel.aa.COO.350
Coordination of Benefits - Private Insurancepel.aa.COO.550
Diagnosis Codingpel.aa.DIA.300
Durable Medical Equipment Items Requiring and Not Requiring Certificate of Medical Necessity (CMN) or DME Information Form (DIF)pel.ph.DUR.400
Electronic Claims Filingpel.aa.ELE.600
Eligibilitypel.aa.ELI.200
Fee Schedule Requestpel.aa.FEE.400
Foot Orthotics for Persons with Diabetespel.ph.ORT.500
Fraudpel.aa.FRA.500
Glossarypel.aa.GLO.500
Habilitative Servicespel.aa.HAB.501
HMSA Member ID Cardspel.aa.HMS.600
HMSA Plan Deductiblespel.aa.HMS.350
HMSA Planspel.aa.HMS.400
How Much to Charge the Memberpel.mp.HOW.500
Immunization Benefits - Medical Pharmacypel.mp.IMM.500
Immunizationspel.aa.IMM.150
Injectable Drug Benefits - Medical Pharmacypel.mp.INJ.200
Injury/Illness Report Formpel.aa.INJ.900
Maximum Allowable Charge (MAC) Review for Pharmaciespel.mp.MAX.700
Medical Policies - Medical Pharmacypel.mp.MED.500
Medicare Advantage PFFSpel.aa.MED.530
Medicare Memberspel.aa.MED.550
Medication Therapy Management: Billing Code Changespel.aa.MED.770
Member ID Card - FEPpel.aa.MEM.500
Membership Connectionpel.aa.MEM.850
Motor Vehicle Insurancepel.aa.MOT.500
Multi - page Claimspel.aa.MUL.500
Nebulizerspel.ph.NEB.500
Payment Determination Criteriapel.aa.PAY.500
Payment Transformation Annual Provider Surveypel.aa.PAY.351
Place of Service (POS) Codespel.aa.PLA.200
Prompt Payment of Clean Claimspel.aa.PRO.500
QNXT Pay Cyclepel.aa.QNX.100
Reimbursing HMSApel.aa.REI.500
Resource Bookspel.aa.RES.500
Setting Up Your Office to Bill HMSA and the Memberpel.mp.SET.500
Specialist & Hospital Payment Transformation - Webinarpel.aa.PAY.350
Specialty Drugs Requiring Precertificationpel.aa.FDA.501
Specialty Pharmaciespel.ph.SPE.500
Supplies - Medical Pharmacypel.mp.SUP.550
Third Party Liabilitypel.aa.THI.500
Vaccine Storage and Handling Recommendationspel.aa.VAC.650
Vectibix (Panitumumab)pel.aa.VEC.500x
Verifying Claim Status and Resubmission of Processed Claims (CMS-1500)pel.aa.RES.600
Workers' Compensationpel.aa.WOR.500
 

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