Clinical Practice Guidelines
HEDIS
Learn about HEDIS, a set of standardized healthcare performance measures used to evaluate plan quality, compare health outcomes, and improve care across key medical conditions.
Hypertension
Guidelines for hypertension services, including coverage, treatment considerations, and billing requirements under HMSA plans.
Opioids
Learn about opioids, including common medications, uses for pain management, and risks such as dependence and overdose.
Osteoporosis
Learn about osteoporosis, including risk factors, screening, prevention, and treatment options to strengthen bones and reduce fracture risk.
Philosophy of Care
Overview of HMSA’s philosophy of care, including commitment to quality health care, member well-being, transparent practices, and fair decision-making in care and coverage.
Primary Preventive Services – Adults (Age 20-65+)
Explore primary preventive services for adults ages 20–65, including screenings, immunizations, and lifestyle interventions for better health outcomes.
Primary Preventive Services – Children (Perinatal-19 Years)
Explore primary preventive services for children from perinatal to age 19, including screenings, immunizations, and care to support healthy development.
Psychological Testing Benefits
Review HMSA psychological testing benefits, including coverage guidelines, eligible services, and requirements for diagnostic and neuropsychological evaluations.
Rheumatoid Arthritis
Learn about rheumatoid arthritis, including symptoms, diagnosis, and treatment options to reduce inflammation, manage pain, and protect joint function.
Screening Pap Smears
Learn about HMSA coverage for routine screening Pap smears, eligibility guidelines, billing codes, and claims filing requirements for providers.