Eligibility

Resources available to assist with patient care due to the Maui fires.

HHIE

Hawaii Health Information Exchange (HHIE) stands with the Maui communities affected by the wildfires and will support health care partners by making its Community Health Record (Health eNet) portal available at no charge for six months to Hawaii providers not currently participating with HHIE who are servicing affected patients.

The secure portal includes demographics, insurance, clinical history, laboratory results, and ambulatory medication histories for Hawaii residents statewide, allowing providers to deliver optimal care to residents in the affected communities.

Please contact info@hawaiihie.org or call 808-441-1374 for more information.

Wireless Priority Service

Providers can sign up for wireless priority service at https://www.fcc.gov/general/wireless-priority-service-wps.

This access provides you with priority to the wireless network when/if service goes down.

You may confirm a member’s eligibility by checking his or her current HMSA member ID card. The card provides you with several pieces of essential information including:

• The HMSA member ID number
• The coverage code
• For HMO members, the name of the PCP

This information should be adequate, in most cases, for you to file claims. However, there may be occasions when you wish to double-check eligibility for a specific patient. For example, you may wish to verify whether the subscriber's spouse or child is covered by the plan.

One simple way to verify eligibility for a specific patient is to use your touch-tone phone to access HMSA's membership records through Membership Connection.

In addition, if you subscribe to the Hawaii Healthcare Information Network (HHIN+), you may access this information electronically.

You may also call a Provider Teleservice Representative at 808-948-6330 on Oahu or 1-800-790-4672 from the Neighbor Islands.

Note: In the past you may have been given verbal confirmation of coverage, but when you submitted your claim, it was rejected because the account had been canceled. Although such occurrences are not common, this type of situation arises from time to time.

Employer groups are responsible for giving HMSA updated employee membership information on a monthly basis. However, there are occasions when this information is received late, or when an employer wishes to cancel an employee's coverage retroactively to the date he or she left employment. For this reason, we ask you to understand that the eligibility information our representatives give you is accurate on the date it is given, but may be subject to change and does not guarantee payment.

Revision History