Claims Filing Information

Electronic Transactions

HMSA offers several electronic transaction options that are electronic data interchange (EDI) compliant. EDI is an electronic communication method that provides standard formats for sending electronic claims, receiving remittance information, and getting eligibility and claim status information.

HMSA supports the following EDI transactions:

• Eligibility verification.
• Claims submission.
• Claim status.
• Electronic funds transfer.
• Remittance advice.
• Report to Provider.

For more information about these products and to learn how to get started, refer to the online EDI HELP GUIDE [PDF] or click here to Contact ETS Outreach. Or you can call the ETS Outreach team at 808-948-6255 on Oahu or 1-800-603-4672, ext. 6255 toll-free on the Neighbor Islands.

Hard-Copy Paper Claims

You can also submit a paper claim for reimbursement. For more information about completing your claim form, refer to the CMS 1500 Claims Filing Highlights and the CMS 1500 Claim Form - General Instructions. Click here for the Claims Mailing Addresses.

If you have a complicated claim question or concern, you can call HMSA’s Customer Relations at 808-948-6330 on Oahu or 1-800-790-4672 toll-free on the Neighbor Islands.

Revision History