Use this form to request precertification for home IV therapy services, including initial treatment, extended therapy periods, and related nursing visits.

Learn HMSA precertification timeliness standards for urgent and routine requests, required submission information, review procedures, and decision timeframes for PPO, HMO, and Akamai Advantage members.

Learn about HMSA’s Pregnancy and Postpartum Support Program, offering maternity nurse support, breastfeeding guidance, education, and postpartum resources.

Access the provider manual for prior authorization, including submission requirements, review processes, and guidelines for obtaining service approvals.

Guidelines for radiation management claim documentation, including required clinical information, medical review criteria, and supporting documentation for specific procedure codes.

Learn HMSA radiology claim documentation requirements, including when clinical information is required, codes needing support, and criteria for medical review and reimbursement.

Review HMSA rehabilitation therapy precertification requirements, including coverage criteria, treatment plan documentation, and approval guidelines for therapy services.

Guidelines for services requiring precertification, including approval requirements, covered services, and processes to ensure proper claim processing.

Learn about alpha-fetoprotein (AFP) testing, including its role in pregnancy screening and detecting certain cancers in men, women, and children.

Overview of utilization management, including HMSA policies, precertification processes, and tools used to ensure appropriate, high-quality, and cost-effective care.