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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.

 

Before Treating the Patient
 
Benefit Policies
 
Claims Filing
 
Forms
 
General Reference
 
Participating With HMSA
 
Payment, Reports and Appeals
 
ALL "BEHAVIORAL HEALTH" DOCUMENTS:
 
Document Name:Document Number:
23-Hour Observationpel.bh.23H.500
Accessibility Standardspel.bh.ACC.501
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 Treatmentpel.bh.ALC.500
Appealing a Pre-certification Denialpel.bh.APP.401
Appealing Processed Claimspel.aa.APP.500
Authorization of Release of Records or Informationpel.bh.AUT.300
Authorizing a Staff Member or Agent to Sign Claim Formspel.bh.AUT.400
Beacon Health Strategiespel.aa.BEA.100
Behavioral Healthpel.aa.BEH.500
Behavioral Health/Substance Misuse Referral Formpel.bh.SUB.600
Benefit Overpaymentpel.aa.BEN.500
Benefit Overpayment - Senior Planspel.aa.BEN.502
Benefits (Behavioral Health) for 65C Pluspel.bh.BEN.600
Benefits for Mental Healthpel.bh.BEN.700
Benefits of Medical Plan Related to Behavioral Healthpel.bh.BEN.800
BlueCard Programpel.aa.BLU.500
Case Management and Reviewpel.bh.CAS.500
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 Informationpel.bh.CLA.100
Claims Timeliness Standardspel.aa.CLA.900
CMS 1500 Claim Form - General Instructionspel.aa.CMS.400
CMS 1500 Claim Form - Vendorspel.aa.CMS.600
Code Bookspel.bh.COD.300
Concurrent Reviewpel.bh.CON.100
Confidentiality of Medical Informationpel.bh.CON.300
Continuity of Care - Behavioral Healthpel.bh.CON.600
Coordination of Benefits - HMSA and Medicarepel.aa.COO.350
Coordination of Benefits - Private Insurancepel.aa.COO.550
CPT Codes for Psychiatric and Psychological Procedurespel.bh.CPT.500
Definitions for Levels of Carepel.bh.DEF.700
Dementia Treatment Exclusionpel.bh.DEM.500
Depression Clinical Practice Guidelinepel.bh.DEP.500
Disease Managementpel.aa.CAR.400
Electroconvulsive Therapypel.bh.ELE.400
Electronic Claims Filingpel.aa.ELE.600
Eligibility - Behavioral Healthpel.bh.ELI.250
Eligibility Reports - Senior Planspel.aa.ELI.700
Eligibility - Senior Planspel.aa.ELI.500
Emergency Room Services - Behavioral Healthpel.bh.EME.500
Family (Conjoint) Psychotherapypel.bh.FAM.500
Federal Employee Program (FEP)pel.aa.FED.500
Fee Schedule Requestpel.aa.FEE.400
Fraudpel.aa.FRA.500
Fraud and Abuse Investigationspel.bh.FRA.600
Genetic Testing Codespel.aa.GEN.100
Glossarypel.aa.GLO.500
Glossary - IV Therapy Indexpel.iv.GLO.500
Hawaii Healthcare Information Network (HHIN)pel.aa.HAW.500
Healthways QuitNet®pel.aa.REA.500
HEDISpel.bh.HED.500
HIPAA Trading Partner Manual, Trading Partner Agreement and Companion Guide Documentspel.aa.HIP.501
HMO Network and Referralspel.bh.HMO.600
HMSA Member ID Cardspel.aa.HMS.600
HMSA Plan Deductiblespel.aa.HMS.350
HMSA Planspel.aa.HMS.400
Hours of Operation for Beacon Health Strategiespel.bh.HOU.500
Injury/Illness Report Formpel.aa.INJ.900
Inpatient Mental Healthpel.bh.INP.500
Intensive Outpatient Programs (IOP) MHpel.bh.INT.250
MAC - Schedule of Maximum Allowable Chargespel.bh.MAC.500
Medical Necessity and Level of Carepel.bh.MED.400
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
Memberspel.aa.MEM.800
Members' Rights and Responsibilities - Behavioral Health Servicespel.bh.BEH.600
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 Providerspel.bh.ONS.700
Outpatient Therapy including Medication Managementpel.bh.OUT.400
Overpayment by HMSApel.bh.OVE.500
Partial Hospital Program (PHP) - MHpel.bh.PAR.500
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
Pre-certificationpel.bh.PRE.100
Privacypel.aa.PRI.500
Provider Credentialing - Behavioral Health Providerspel.bh.PRO.551
Psychological & Neuropsychological Testpel.bh.PSY.500
Psychological Testing Benefitspel.bh.PSY.600
QNXT Pay Cyclepel.aa.QNX.100
Quality and Service Recognition Programpel.bh.QUA.400
Quality Improvement Programpel.aa.QUA.500
Recovery Letterpel.bh.REC.600
Referrals - General Informationpel.aa.REF.400
Reimbursing HMSApel.aa.REI.500
Report to Providerpel.aa.REP.500
Residential Treatment (RTC)pel.bh.RES.200
Resubmissions and Tracers - IV Therapy Indexpel.iv.RES.600
Serious Mental Illnesspel.bh.SER.200
Services to Family Memberspel.aa.SER.650
Smoking Cessationpel.aa.SMO.500
Specialist & Hospital Payment Transformation - Webinarpel.aa.PAY.350
Submitting HIPAA EDI Transactions to HMSApel.aa.EDI.500
Termination of a Participating Provider Agreementpel.bh.TER.600
The ASAM Criteriapel.bh.ASA.600
Third Party Liabilitypel.aa.THI.500
Two-for-one Benefit Exchangepel.bh.TWO.500
Updating Your Provider Recordpel.aa.UPD.500
Utilization Managementpel.aa.UTI.500
Vacation Supplies of Prescription Medicationpel.bh.VAC.400
Verifying Claim Status and Resubmission of Processed Claims (CMS-1500)pel.aa.RES.600
Workers' Compensationpel.aa.WOR.500
Workers Compensation - IV Therapy Indexpel.iv.WOR.500
 

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