Provider Portal - At Your Fingertips

HMSA is pleased to offer this comprehensive, frequently updated online reference for healthcare providers who serve HMSA members. We encourage you to familiarize yourself with the Provider Resource Center's sections, particularly the following:

Termination Notification: Cozeva Patient Attestation Form

Starting May 1, you’ll no longer be able to use Cozeva to manage your patient panel, such as adding or removing patients. read more...1

Get Ready for Coreo!

Get Ready for Coreo! Webinar for PCPs and Staff Wednesday, April 25, 2018 12:30 p.m. - 2:00 p.m. Agenda: • Updates • Effectively Manage Your Panel • Supplemental Data Reporting • Looking Ahead Registration is required read more...1

Coreo Launch Postponed to May 1, 2018

We're moving the April 1 launch of Coreo to May 1, 2018, to make sure everything's in place so you and your staff can work confidently with the system and have the best experience possible. Thank you for attending Coreo provider training sessions we've been holding since February. In the meantime, please continue to use Cozeva, which will be available while we prepare to launch Coreo. read more...1

HealthPro News April 2018 Edition

What’s inside: • Contract Notification • Pharmacy • Policy News • and much more… read more...1

Provider Directory Update Reminder

Accurate information on your practice is critical to our members who rely on our directories. They need up-to-date information to make it easier to contact providers in our network. Also, the Centers for Medicare & Medicaid Services (CMS) requires us to have current information. read more...1

2018 HMSA Payment Transformation Program Guide

The 2018 Payment Transformation Program Guide includes information for PCPs and POs. The PT program replaced HMSA’s payments that were based on existing fee schedules, pay-for-quality (P4Q) programs, and patient-centered medical home (PCMH) programs. Log in to HHIN to see the 2018 Payment Transformation Program Guide read more...1
  • Cozeva Patient Attestation Form

  • Get Ready for Coreo!

  • Coreo Launch Postponed

  • HealthPro News April 2018 Edition

  • Provider Directory Update

  • 2018 HMSA Payment Transformation Program Guide

Reference Information6

Provider Library7

Contains HMSA’s medical policies8, formulary9 information, claims filing10 guidelines, payment and appeals11 processes, behavioral health12 policies, and other important information

Plan Libraries13

View specific policies and processes associated with our QUEST Integrated14 (Medicaid) and Akamai15 (Medicare) programs

Programs16

Learn about incentive programs offered by HMSA, such as Payment Transformation17, Pay for Quality18, & PCMH19 Visit Medicare Star Ratings20 for Stars-related measure reference guides and other tools

Training21

View webinars and materials on Payment Transformation, Pay for Quality, ICD-10, QUEST Integration, Akamai Advantage, and other topics

Out of Area Policies22

Look up medical policies and pre-certification / pre-authorization information for out-of-area members

FAQ's23

View providers’ questions regarding provider support, claims, medical policies, pre-certification, appeals, contracting, radiology management, and other topics.

Contact Us24

Helps you find contact information for the various departments at HMSA that are here to serve you.

Tools & Forms25

Tools26

Access online tools such as Cozeva27, HHIN28 (or HHIN’s documentation29), and HMSA’s Online Care30

Forms31

Download, complete, and return forms for servicing commercial32, QUEST Integrated33, and Akamai members15. Forms on behavioral health34 care are also available.

Useful Websites35

A list of websites which we think may be helpful to you, such as State and Federal agencies, coding references, etc.

News & Letters36

News37

Read about recent news that impacts providers, or view the archive of previous news that may still apply

Communication Archive38

Review HMSA communications to providers via HealthPro News and other channels

Join Our Network39

Learn About HMSA40

Learn about HMSA’s mission, our history, the plans we offer, and how to apply to join our network.

Join HMSA41

Begin the process of joining HMSA’s provider network.