HMSA Medicare Advantage Plans
HMSA Medicare Advantage Plans
HMSA Medicare Advantage Plan Comparison
Appeals
Claims Mailing Address Information:
Fee Schedules
- Medicare Fee Schedule HMSA Akamai Advantage pays according to the Medicare Fee Schedule, found here through our intermediary. To the extent an Average Sales Price file is utilized, HMSA carries two places after the decimal point for calculation of the amount due for a line item, then follows standard rounding procedures in determining the final payment amount.
Forms
Medicare Diabetes Prevention Program
Medicare Star Ratings
- Medicare Risk Adjustment and STARs (Video) – September 2021
- Medicare Risk Adjustment and STARs [PDF] – September 2021
- Medicare Star Ratings
Notifications
- Provider Practices [PDF] Centers for Medicare & Medicaid Services (CMS) Guidelines for distributing marketing collateral.
- Correct Billing Instructions for Modifiers GA, GX, GY and GZ
- Two-Midnight Rule and Observation Room Implementation and Billing [PDF]
- HMSA Medicare Advantage Diabetic Test Strips
Pharmacy and Formulary
Precertification/Prior-authorization:
- Precertification Requirements – Medicare Advantage Plans
- Durable Medical Equipment (DME) Codes Requiring Prior Authorization for Medicare Advantage (PPO/HMO)
- Plan-Directed Care Prior Authorization Checklist [PDF]
Sequestration
Training
- Medicare Advantage Overview Presentation
- Medicare Parts C and D Fraud, Waste and Abuse and General Compliance Training
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform.
|