Admission Notice, Census Report

Participating hospitals are required to submit, in a timely manner, information regarding HMSA members admitted to an inpatient setting.

Admission Notice

Participating hospitals are responsible for furnishing daily admission notices for all HMSA members admitted during the previous 24 hours.

Census Report

Participating hospitals must submit daily or weekly census reports that include information about admissions, inpatient stays and discharges for all HMSA members.

Required Information

The following information must be included on admission notices and census reports, where applicable:

• Facility name and HMSA provider number
• Patient's name
• HMSA member ID number and coverage code
• Subscriber's name
• Admission date and time
• Length of stay
• Discharge diagnosis
• Discharge date
• Medical record number
• Billing or account number
• Patient's date of birth
• Patient's gender
• Attending physician's name
• Referring physician's name (if applicable)
• Admitting diagnosis(es)
• Surgical procedure (if applicable)
• Hospital charges
• Insurer(s) other than HMSA (if any)
• Third party liability information (if applicable), including the accident date, insurer name, subscriber name and policy number

Admission notices and census reports should be mailed or faxed to:

Medical Review Unit/6th Floor
HMSA - Medical Management Department
P.O. Box 2001
Honolulu, HI  96805

Fax:  808-944-5611

Revision History