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Reimbursing HMSA

 

On occasion providers may discover that they received an overpayment caused by a billing error such as the wrong patient's name being used, the service being billed under an incorrect member ID number or another carrier having paid the claim in full. When such an overpayment occurs, providers may reimburse HMSA in one of two ways:

Note: If you are refunding HMSA because you received payment from a TPL carrier, please also include:

Providers sending a single check to cover the refund for more than one member should itemize the refund to include all of the above-referenced information for each member.

 

Checks should be mailed to:

 

HMSA-Cashier

P.O. Box 4720

Honolulu, HI  96812

 

 

Recovery Requests

When HMSA discovers that an error has been made in processing a claim, or when HMSA was incorrectly billed for services that should have been billed to a liable third party, we will send a letter informing the provider of the overpayment.  If the provider believes our determination is incorrect, the provider can contact HMSA's Benefits Recovery Unit at the phone number listed on the letter, or provide us with a written response explaining the reason the provider believes our determination to be incorrect. The response should be sent to:

 

Benefits Recovery Unit

HMSA - Claims Administration Dept.

P.O. Box 860

Honolulu, HI  96808

 

If we have not heard from the provider within 60 days of the date of our letter, we will deduct the undisputed overpayment from the provider's next remittance.

 

 

First Published:02/11/2001
Latest Revision:05/16/2012
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