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:

Changes to Insulin Brands Covered by Formulary

To keep insulin accessible and affordable, we’re making changes to the list of insulin brands that we pay for on behalf of our members. Starting December 1, 2016, Novolin® (with the exception of ReliOn® Novolin products), Novolog®, and Lantus® will be the preferred insulin brands on our commercial plan formularies.
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Provider Portal – Redesigned

Welcome to the new and improved Provider Portal! The provider portal has been redesigned to improve your overall experience by:
  1. Updating the navigation to allow you to more easily find what you are looking for.
  2. Adding a feature to display important news and announcements
  3. Including descriptions of the contents of each section below the important news and announcement feature, so that you can more efficiently find what you are looking for.
read more...
  • Changes to Insulin Brands Covered by Formulary

  • Provider Portal – Redesigned

Reference Information

Provider Library

Contains HMSA’s medical policies, formulary information, claims filing guidelines, payment and appeals processes, behavioral health policies, and other important information

Plan Libraries

View specific policies and processes associated with our QUEST Integration (Medicaid) and Akamai (Medicare) programs

Programs

Learn about incentive programs offered by HMSA, such as Payment Transformation, Pay for Quality, & PCMH

Training

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

Out of Area Policies

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

FAQ's

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

Contact Us

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

Tools & Forms

Tools

Access online tools such as Cozeva, HHIN (or HHIN’s documentation), and HMSA’s Online Care

Forms

Download, complete, and return forms for servicing commercial, QUEST Integration, and Akamai members. Forms on behavioral health care are also available.

Useful Websites

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

News & Letters

News

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

Communication Archive

Review HMSA communications to providers via HealthPro News and other channels

Join Our Network

Learn About HMSA

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

Join HMSA

Begin the process of joining HMSA’s provider network.