Medical
Chemotherapy, Home Intravenous
Review HMSA guidelines for home intravenous chemotherapy, including eligibility criteria, documentation requirements, precertification, and claims billing instructions.
Childhood Immunizations
Guidelines for childhood immunizations, including coverage, ACIP recommendations, and vaccine schedules for HMSA members.
Coreo Resource Library
Explore the HMSA Coreo Resource Library with training webinars, guides, and support materials for providers using the Coreo care management platform.
Cosmetic Procedures - Claim Documentation Requirements
Review HMSA cosmetic procedures claim documentation requirements, including operative reports, photos, and supporting records needed for accurate claim submission.
Current Required Prior Authorization Code List
View the required prior authorization code list, including services and procedures that need approval, with guidelines to support compliant claims processing.
Custom-Fabricated Prosthetic Devices
Coverage guidelines for custom‑fabricated prosthetic devices, including definitions, limitations, and precertification requirements.
Debridement
Billing guidelines for debridement services, including when debridement is separately payable and documentation requirements for claim submission.
eviCore healthcare Outpatient PT, OT, and Chiropractic Services Precertification Programs
Guidelines for eviCore precertification programs for outpatient PT, OT, and chiropractic services, including authorization requirements and submission processes.
Evolent Health Utilization Management Programs
Learn about utilization management programs, including care review processes, authorization requirements, and strategies to support appropriate healthcare services.
External Ocular Photography
Learn about external ocular photography, including clinical uses, coverage, and guidelines for documenting eye conditions and supporting diagnosis.