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This document is a provider agreement between the Hawaii Medical Service Association (HMSA) and a participating provider for the provision of durable medical equipment and supplies to members.
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How to fill out HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT
01
Obtain the HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT form from the HMSA website or office.
02
Review the eligibility requirements to ensure your DME/Supplies practice meets the necessary standards.
03
Fill in your business information, including the name, address, and contact details.
04
Provide your National Provider Identifier (NPI) number and any necessary tax identification numbers.
05
Detail the types of durable medical equipment and supplies you intend to provide.
06
Read and understand the terms and conditions outlined in the agreement.
07
Sign and date the agreement at the designated areas.
08
Submit the completed form along with any required documentation to HMSA for review.
09
Await confirmation and possibly further instructions or requests for additional information from HMSA.
Who needs HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT?
01
Healthcare providers or businesses that offer durable medical equipment and supplies in Hawaii.
02
Organizations that want to participate in HMSA's network to provide services to its members.
03
Practitioners seeking reimbursement and recognition for the durable medical equipment and supplies they supply.
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What is HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT?
The HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT is a contract that establishes the terms and conditions under which healthcare providers supply durable medical equipment and supplies to patients covered under HMSA insurance plans.
Who is required to file HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT?
Durable medical equipment and supplies providers who wish to participate in the HAWAII MEDICAL SERVICE ASSOCIATION network and receive reimbursement for services provided to HMSA members are required to file this agreement.
How to fill out HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT?
To fill out the agreement, providers must complete all sections of the form accurately, including their business information, services offered, signatures, and any necessary documentation as outlined in the agreement instructions.
What is the purpose of HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT?
The purpose of the agreement is to define the relationship between HMSA and the provider, ensuring compliance with policies, facilitating reimbursement processes, and ensuring that patients receive necessary medical equipment and supplies.
What information must be reported on HAWAII MEDICAL SERVICE ASSOCIATION PARTICIPATING DURABLE MEDICAL EQUIPMENT & SUPPLIES PROVIDER AGREEMENT?
The information that must be reported includes business details of the provider, types of equipment and supplies offered, billing practices, service location, and compliance with applicable laws and regulations.
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