Please print and complete the appropriate EDI Contract form(s) below and return to HMSA via fax at 948-6008.
- Access Request and Contract to Preserve Confidential Information Form [PDF]
- Change to HHIN+ Provider List Form [PDF]
- Electronic Trading Partner Agreement [PDF]
- Business Associate Authorization Form [PDF]
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform |