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:

Tell Your Diabetic Patients about Upcoming Event: Taking Control of Your Diabetes "TCOYD"

There is an upcoming diabetes conference which promises to inspire, motivate, and educate members in a fun and interactive way. Please inform your diabetic patients about this upcoming event. From the "TCOYD" event information brochure: "We throw out the sterile, grey, clinical setting and hit you with: Inspiring speakers. HUMOR. Motivating workshops. EMPOWERING educational lectures. Hands-on activities. An interactive health fair brimming with exhibitors (aka lots of free goodies and giveaways). A YUMMY LUNCH and the opportunity to connect and make some new friends along the way."
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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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SilverSneakers® for Complete Plus members starting Jan 1, 2017

HMSA has added the SilverSneaker benefit, previously available to Medicare Advantage members only through the Complete plan, to the Complete Plus plan. Physicians can inform members about this important benefit change and encourage Complete Plus plan members to use the benefit to be more fit in 2017.
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Reminder for License Renewal

Please take a moment to check the expiration date on your state license. If you haven’t already done so, please renew your license as soon as possible to avoid being terminated as an HMSA participating provider. This request is especially extended to Physical Therapists, Occupational Therapists and Marriage & Family Therapists.
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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...
  • Taking Control of Your Diabetes "TCOYD"

  • Changes to Insulin Brands Covered by Formulary

  • SilverSneakers® for Complete Plus members starting Jan 1, 2017

  • Reminder for License Renewal

  • 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 Integrated (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 Integrated, 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.