Guidelines for abortion and pregnancy termination coverage, including benefit verification, federal plan limitations, precertification, and claims filing requirements.

Learn about administrative requirements for select behavioral health services, including documentation, authorization, and billing guidelines for compliance and quality care.

Learn about HMSA’s Annual Preventive Health Evaluation (APHE) benefit, eligibility requirements, covered annual wellness and physical exams, billing codes, and preventive care guidelines for members age 22 and older.

Learn how to appeal an HMSA precertification denial, including timelines, review levels, and options for standard and expedited appeals.

Guidelines for assistant surgeon services, including eligibility, billing requirements, modifier use, and reimbursement guidelines.

Access HMSA forms to authorize the release of records or information. Download, complete, and submit required documents for sharing protected health information.

Automated nerve conduction tests at point of care: technology, diagnostic applications for neuropathy and carpal tunnel, and HMSA policy coverage.

Guidelines for breast reconstruction services, including coverage after mastectomy, symmetry procedures, complications, and claims filing requirements.

Learn key guidelines for chemotherapy coding, including proper use of CPT, HCPCS, and documentation requirements to ensure accurate claims and reimbursement.

Learn how chemotherapy J-codes are used to accurately bill and report injectable cancer drugs in healthcare claims, ensuring proper reimbursement and compliance.