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Behavioral Health Information



Prior to treating an HMSA member for behavioral health-related issues, find out precertification requirements, plans and eligibility information, forms, benefit policies, and other party liability (e.g., workers’ compensation).


We also have post-service information such as claims filing, payments, overpayments, and appeals.


If you don’t find what you need from the links on this page or in our general reference section, please call our Behavioral Health Program at 695-7700 on Oahu or 1-855-856-0578 toll-free on the Neighbor Islands.


Document Name:Document Number:
Acceptable Invoice Submissionspel.aa.ACC.100
Accessibility Standards for Behavioral Health
Adolescent Substance Abuse Assessments - CSAC Billingpel.aa.ADO.500
Advance Directives - Senior Planspel.aa.ADV.500
Agent Authorizationpel.aa.AGE.500
Alcohol and Drug/Chemical Dependency
Appealing a Precertification
Appealing Processed Claimspel.aa.APP.500
Authorization of Release of Records or
Authorizing a Staff Member or Agent to Sign Claim
Beacon Health Optionspel.aa.BEA.100
Behavioral Healthpel.aa.BEH.500
Behavioral Health/Substance Misuse Referral
Benefit Overpaymentpel.aa.BEN.500
Benefit Overpayment - Senior Planspel.aa.BEN.502
Benefits for Mental
Benefits of Medical Plan Related to Behavioral
BlueCard Programpel.aa.BLU.500
Case Management and
Claims Filing Informationpel.aa.HIP.500
Claims Filing Instructions - Senior Planspel.aa.CLA.500
Claims for AIU Companypel.aa.AIU.500
Claims Submission Instructions - Senior Planspel.aa.CLA.850
Claim Status
Claims Timeliness Standardspel.aa.CLA.900
CMS 1500 Claim Form - General Instructionspel.aa.CMS.400
CMS 1500 Claim Form - Vendorspel.aa.CMS.600
Confidentiality of Medical
Continuity of Care - Behavioral
Coordination of Benefits - HMSA and Medicarepel.aa.COO.350
Coordination of Benefits - Private Insurancepel.aa.COO.550
CPT Codes for Psychiatric and Psychological
Definitions for Levels of
Dementia Treatment
Depression Clinical Practice
Disease Managementpel.aa.CAR.400
Electronic Claims Filingpel.aa.ELE.600
Eligibility - Behavioral
Eligibility - Senior Planspel.aa.ELI.500
Emergency Room Services - Behavioral
Family (Conjoint)
Federal Employee Program (FEP) - Basic Option (enrollment code 111, 112 and 113)pel.aa.FEP.501
Federal Employee Program (FEP) - FEP Blue Focuszav_pel.aa.FEP.503
Federal Employee Program (FEP) - Standard Option (enrollment code 104, 105 and 106)pel.aa.FED.502
Fee Schedule Requestpel.aa.FEE.400
Fraud and Abuse
Genetic Testing Codespel.aa.GEN.100
Healthways QuitNet®pel.aa.REA.500
HHIN Documents & Informationhhin-prc-home
HIPAA Trading Partner Manual, Trading Partner Agreement and Companion Guide Documentspel.aa.HIP.501
HMO Network and Referrals for Behavioral Health and Substance Abuse Treatment
HMSA Member ID Cardspel.aa.HMS.600
HMSA Plan Deductiblespel.aa.HMS.350
HMSA Planspel.aa.HMS.400
Hours of Operation for Beacon Health
Injury/Illness Report Formpel.aa.INJ.900
Inpatient Mental
Intensive Outpatient Programs (IOP)
MAC - Schedule of Maximum Allowable
Medical Necessity and Level of
Medical Recordspel.aa.MED.500
Medicare Advantage PFFSpel.aa.MED.530
Member's Rights and Responsibilitiespel.aa.MEM.750
Member ID Card - FEPpel.aa.MEM.500
Members' Rights and Responsibilities - Behavioral Health
Membership Connectionpel.aa.MEM.850
Motor Vehicle Insurancepel.aa.MOT.500
Multi - page Claimspel.aa.MUL.500
Office Visits and Consultationspel.aa.OFF.400
On-Site Review of High-Volume Behavioral Health
Outpatient Therapy including Medication
Overpayment by
Partial Hospital Program (PHP) -
Payment Determination Criteriapel.aa.PAY.500
Payment Transformation Annual Provider Surveypel.aa.PAY.351
Philosophy of Carepel.aa.PHI.500
Place of Service (POS) Codespel.aa.PLA.200
Provider Credentialing - Behavioral Health
Psychological & Neuropsychological
Psychological Testing
QNXT Pay Cyclepel.aa.QNX.100
Quality and Service Recognition
Quality Improvement Programpel.aa.QUA.500
Referrals - General Informationpel.aa.REF.400
Reimbursing HMSApel.aa.REI.500
Report to Providerpel.aa.REP.500
Residential Treatment (RTC)
Serious Mental
Services to Family Memberspel.aa.SER.650
Sexual Abuse Case Managementpel.aa.SAC.100
Specialist & Hospital Payment Transformation - Webinarpel.aa.PAY.350
Submitting HIPAA EDI Transactions to HMSApel.aa.EDI.500
Termination of a Participating Provider
Third Party Liabilitypel.aa.THI.500
Two-for-one Benefit
Updating Your Provider Recordpel.aa.UPD.500
Utilization Managementpel.aa.UTI.500
Vacation Supplies of Prescription
Verifying Claim Status and Resubmission of Processed Claims (CMS-1500)pel.aa.RES.600
Workers' Compensationpel.aa.WOR.500

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