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HMSA Directory

Revised: 10/04/2011 by COMM


Provider Resources

Appeals Unit

Blue Cross and Blue Shield of Hawaii BlueCard Department

Case Management/Care Coordination/Managed Care Services

Department of Human Services Hotline (for QUEST Integration-related inquiries)

EDI Support Center

Eligibility (Membership Connection)

Federal Employee Program (FEP) of Blue Cross and Blue Shield of Hawaii

Hawaii Healthcare Information Network (HHIN)

HMSA's Behavioral Health Services - Commercial, Fed 87, FEP (Beacon Health Strategies)

HMSA's Behavioral Health Services - QUEST Integration (Beacon Health Strategies)

HMSA's Disease Management Services

HMSA's Online Care

Operating Engineers Local 3 - Addictions Recovery Program

Pharmacy

Pre-certification Unit

Privacy Office

Provider Correspondence

Provider Data and Contract Administration

Provider Services (Automated Answering System)

Provider Services for The HMSA Plan for QUEST Integration Members

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Appeals Unit


Phone

  • Oahu - (808) 948-5090
  • Neighbor Islands - 1 (800) 462-2085 toll-free

 

Fax

  • All islands - 1 (808) 952-7546 on Oahu

 

Mail

  • For Private Business appeals:

HMSA

Member Advocacy and Appeals

P.O. Box 1958

Honolulu, HI 96805-1958

 

OR 

Email: appeals@hmsa.com

 

  • For QUEST Integration appeals:

HMSA QUEST Integration Grievance Coordinator - QI Room 525

P.O. Box 860

Honolulu, HI 96808-9988

 

 


Blue Cross and Blue Shield of Hawaii BlueCard Department


General

 

Phone

  • Oahu - (808) 948-6280
  • Neighbor Islands - 1 (800) 648-3190 toll-free

 

Fax

  • Oahu - (808) 948-5947
  • Neighbor Islands - 1 (800) 459-3961 or 1 (800) 459-3962 toll-free

 

 

To check eligibility for BlueCard members:

 

Phone

  • All islands - 1 (800) 676-BLUE (2583) toll-free

 


Case Management/Care Coordination/Managed Care Services


Program Intake

 

Phone

  • Oahu - (808) 440-7057
  • Neighbor Islands - 1 (855) 211-4527 toll-free

Available Monday to Friday, 8 a.m. to 4 p.m. After-hours calls are received by a voice mail system and answered the following business day.

 

Fax

  • For case management: All islands - 1 (808) 944-5614 on Oahu
  • For care coordination (QUEST Integration only): All islands - 1 (808) 944-5607 on Oahu

 


Department of Human Services Hotline (for QUEST Integration-related inquiries)


Phone

  • All islands - 1 (808) 692-8099 on Oahu


 


EDI Support Center


Phone

  • Oahu - (808) 948-6355
  • Neighbor Islands - 1 (800) 377-4672 toll-free

 

Fax

  • All islands - 1 (808) 948-6008 on Oahu

 


Eligibility (Membership Connection)


Phone

  • Oahu - (808) 948-6244
  • Neighbor Islands - 1 (800) 552-8507 toll-free

Member ID number required. For instructions, see Membership Connection.

 


Federal Employee Program (FEP) of Blue Cross and Blue Shield of Hawaii


General

 

Phone

  • Oahu - (808) 948-6281
  • Neighbor Islands and Mainland - 1 (800) 966-6198 toll-free

 

Fax

  • All islands - 1 (808) 948-6800 on Oahu

 

Mail

 

HMSA - FEP

P.O. Box 1346

Honolulu, HI 96807-1346

 

 

 

Retail Pharmacy - Provider Service (for pre-authorization for select prescription drugs):

 

Phone

  • All islands - 1 (877) 727-3784 toll-free

 

 

 

Retail Pharmacy - Customer Service (for pre-authorization for select prescription drugs):

 

Phone

  • All islands - 1 (800) 624-5060 toll-free


 


Hawaii Healthcare Information Network (HHIN)


For new user registration and setup:

 

Phone

  • Oahu - (808) 948-5851
  • Neighbor Islands - 1 (800) 603-4672, ext. 5851, toll-free

 

 

 

HHIN Help Desk (for technical support):

 

Phone

  • Oahu - (808) 948-6446
  • Neighbor Islands - 1 (800) 760-4672 toll-free


 


HMSA's Behavioral Health Services - Commercial, Fed 87, FEP (Beacon Health Strategies)


For questions regarding:

  • Selecting a behavioral health practitioner for a member.
  • Behavioral health services.
  • Clinical issues relating to patient care.
  • Intensive case management.
  • Behavioral health triage.
  • Pre-certification of benefits.
  • Two-for-one benefit exchanges.

 

Phone

  • Oahu and Neighbor Islands - 1 (855) 856-0578. Available Monday to Friday 8 a.m. to 4 p.m. After hours on-call assistance available.

 

Fax

  • All Islands - 1 (808) 695-7799

 

Mail

 

HMSA's Behavioral Health Services - Commercial, FEP, Fed 87 (Beacon Health Strategies)

599 Farrington Highway, Suite 300

Kapolei, HI 96707

 


HMSA's Behavioral Health Services - QUEST Integration (Beacon Health Strategies)


For questions regarding:

  • Selecting a behavioral health practitioner for a member.
  • Behavioral health services.
  • Clinical issues relating to patient care.
  • Intensive case management.
  • Behavioral health triage.
  • Pre-certification of benefits.
  • Two-for-one benefit exchange.

 

Phone

  • Oahu - (808) 695-7700
  • Neighbor Islands - 1 (855) 856-0578 toll-free

Available Monday to Friday, 7:30 a.m. to 4:30 p.m. After-hours on-call assistance available. 

 

Fax

  • Oahu - (808) 695-7790
  • Neighbor Islands - 1 (855) 539-5880 toll-free

 
 

Mail

 

Beacon Health Strategies

599 Farrington Hwy., Suite 300

Kapolei, HI 96707

 

 

 


HMSA's Disease Management Services


Phone

  • All islands - 1 (800) 499-5036 toll-free. Available Monday to Friday, 8 a.m. to 7 p.m., and Saturday, 8 a.m. to 5 p.m.

 

Fax

  • All islands - 1 (808) 948-8242

 

Mail

 

HMSA's Disease Management Services

599 Farrington Highway, Suite 300

Kapolei, HI 96707-2028

 


HMSA's Online Care


Phone

  • Oahu - (808) 948-6013
  • Neighbor Islands - 1 (866) 939-6013 toll-free

Available seven days a week, 24 hours a day, except for brief maintenance work scheduled during low-usage periods.

 


Operating Engineers Local 3 - Addictions Recovery Program


Phone

  • Oahu - (808) 842-4624
  • Neighbor Islands - 1 (800) 562-3277 toll-free

 

Fax

  • All islands - 1 (510) 748-7445

 


Pharmacy


Fax

  • All islands - (808) 533-1482 on Oahu

 

Mail

 

Sr. Benefit Delivery Specialist

HMSA - Pharmacy Management

P.O. Box 860

Honolulu, HI 96808-0860

 


Pre-certification Unit


General

 

Phone

  • Oahu - (808) 948-6464
  • Neighbor Islands - 1 (800) 344-6122 toll-free
  • Mainland - 1 (800) 877-5394 toll-free

Available Monday to Friday, 8 a.m. to 4 p.m. Hawaii Standard Time. After-hours calls are received by a voice mail system and answered the following business day.

 

Fax

  • All islands - 1 (808) 944-5611 on Oahu

 

 

 

For questions about the utilization management process:

 

Mail

 

HMSA - Medical Management Department

P.O. Box 2001

Honolulu, HI 96805-2001

 


Privacy Office


Mail

 

HMSA - Privacy Office

Privacy Official, 8th Floor

P.O. Box 860

Honolulu, HI 96808-0860

 


Provider Correspondence


Phone

  • Oahu - (808) 948-6330
  • Neighbor Islands - 1 (800) 790-4672 toll-free

 

Fax

  • Oahu - (808) 948-8201
  • Neighbor Islands - 1 (877) 439-8201

 

 

Mail

 

HMSA - Customer Relations

ATTN: Research and Correspondence

P.O. Box 860

Honolulu, HI 96808-0860

 


Provider Data and Contract Administration


For registration, provider number assignment, questions regarding eligible fees, and address changes.

 

Phone

  • Oahu - (808) 952-7847
  • Neighbor Islands
    • For all providers except dental: Call 1 (800) 790-4672 toll-free and ask to be transferred to the Provider Information Unit.
    • For dental providers: Call 1 (800) 792-4672 toll-free and ask to be transferred to the Provider Information Unit.

 

Mail

HMSA

Provider Data Administration

P.O. Box 860

Honolulu, HI 96808-0860

 

 

Email

  • provider_data@hmsa.com

 

 


Provider Services (Automated Answering System)


Phone

  • Oahu - (808) 948-6330
  • Neighbor Islands - 1 (800) 790-4672 toll-free

 

Fax

  • Oahu - (808) 948-6887
  • Neighbor Islands - 1 (800) 540-1668 toll-free

 

 


Provider Services for The HMSA Plan for QUEST Integration Members


General 

 

Phone

  • Oahu - (808) 948-6486
  • Neighbor Islands - 1 (800) 440-0640 toll-free

Available seven days a week, 24 hours a day.

 

Fax

  • Oahu - (808) 948-5648
  • Neighbor Islands - 1 (800) 960-4672 toll-free

 

Mail

 

HMSA - QUEST Integration Operations

P.O. Box 3520

Honolulu, HI 96811-3520

 

 

 

Benefit pre-certification for managed care program services:

 

Fax

  • All islands - (808) 944-5611 on Oahu

 

 

For providers or members who need immediate assistance after hours for urgent or emergent cases requiring transportation arrangements, eligibility verification, or help finding a participating provider:

 

Phone

  • All islands - 1 (800) 820-7248 toll-free. Available seven days a week, 4:30 p.m. to 7:45 a.m.

 

 

 

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CVS Caremark

CVS Caremark Contact Numbers

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CVS Caremark Contact Numbers


CVS Caremark

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Claims

CMS 1500 Claims (Professional)

UB-04 Claims (Facility)

AIU Travel Insurance (all claims)

BlueCard Program (all claims)

Dental Claims

Dental - Corrected Claims

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CMS 1500 Claims (Professional)


Mail

 

HMSA - CMS 1500 Claims (Professional)

P.O. Box 44500

Honolulu, HI 96804-4500


 

 


UB-04 Claims (Facility)


Mail

 

HMSA - UB-04 Claims (Facility)

P.O. Box 32700

Honolulu, HI 96803-2700

 


AIU Travel Insurance (all claims)


Mail

 

AIU Insurance Company

P.O. Box 1710

Honolulu, HI 96806-1710

 

 


BlueCard Program (all claims)


Mail

 

HMSA - BlueCard Program

P.O. Box 2970

Honolulu, HI 96802

 

 


Dental Claims


Fax

  • All islands - 1 (888) 255-0876 toll-free

 

 

Mail

 

HMSA - Dental

P.O. Box 1187

Elk Grove Village, IL 60009-1187

 

 


Dental - Corrected Claims


Fax

  • All islands - (808) 538-8996 on Oahu

 

 

Mail

 

HMSA - Dental Services

Attn: Corrected Claims

P.O. Box 1320

Honolulu, HI 96807-1320

 

 

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Dental Provider Resources

Dental Provider Services

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Dental Provider Services


General

 

Phone

  • Oahu - (808) 948-6440
  • Neighbor Islands - 1 (800) 792-4672 toll-free

 

 

Fax

  • Oahu - (808) 538-8996

 

 

Mail

 

HMSA - Dental

P.O. Box 1320

Honolulu, HI 96807-1320

 

 

Email

  • dentalservice@mail.bshi.net

 

 

Dental Provider Services Field Representatives


 

Phone

  • Oahu - (808) 538-8952 (Robin Williams) or (808) 538-8951 (Kathy Oide)

 

 

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Member Resources (other more specific service numbers above)

Neighbor Island Members

Group/Individual PPO (Preferred Provider Plan) Members

Health Plan Hawaii and Other HMSA HMO Members

Medicare Program (65C Plus and Akamai Advantage) Members

Federal/State/County PPO Members

Membership Department

TTY (Text Telephone)

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Neighbor Island Members


General service numbers. Some (more specific) member service numbers may be found above.

 

Phone

  • Hilo - (808) 935-5441
  • Kahului - (808) 871-6295
  • Kailua-Kona - (808) 329-5291
  • Lanai - 1 (800) 639-4672 toll-free
  • Lihue - (808) 245-3393
  • Molokai - 1 (800) 639-4672 toll-free

 

 

Neighbor Island members should call their local HMSA customer service number for all questions except those regarding:

  • BlueCard, national accounts, and out-of-state claims.
  • Dental services.
  • Federal Employee Program (FEP).
  • Individual Plan Billing.
  • Membership cards and record changes.
  • The HMSA Plan for QUEST Integration Members.

 

For questions related to these topics, please see the applicable sections in this directory.


 


Group/Individual PPO (Preferred Provider Plan) Members


Phone

  • Oahu - (808) 948-6111
  • Neighbor Islands and Mainland - 1 (800) 776-4672 toll-free


 


Health Plan Hawaii and Other HMSA HMO Members


Phone

  • Oahu - (808) 948-6372
  • Neighbor Islands and Mainland - 1 (800) 776-4672 toll-free


 


Medicare Program (65C Plus and Akamai Advantage) Members


Phone

  • Oahu - (808) 948-6000
  • Neighbor Islands and Mainland - 1 (800) 776-4672 toll-free


 


Federal/State/County PPO Members


Phone

  • All islands - 1 (808) 948-6499 on Oahu


 


Membership Department


For individual plan billing, membership cards, and record changes (except QUEST Integration):

 

Phone

  • Oahu - (808) 948-6140
  • Neighbor Islands and Mainland - 1 (800) 782-4672 toll-free


 


TTY (Text Telephone)


Phone

  • Oahu - (808) 948-6222
  • Neighbor Islands - 1 (877) 298-4672 toll-free


 

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Latest Revision:06/10/2016

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