Get the free HMSA Provider Enrollment and Credentialing Application - 7/16

1 Rev. 6/2016 HSA PROVIDER ENROLLMENT AND CREDENTIALING APPLICATION. PLEASE PRINT USING BALLPOINT PEN OR TYPE. (Write N/A in non-applicablesections.)

How to fill out hmsa provider enrollment and

How to fill out HMSA provider enrollment and?

1. Start by gathering the necessary information and documents. You will need to have your personal information, such as name, contact details, and social security number, readily available. Additionally, gather information about your practice or organization, including tax identification number, NPI number, and any relevant certifications or licenses.
2. Visit the HMSA website or contact their provider enrollment department to obtain the necessary forms. You may need to create an account or log in to access the forms online. Make sure to review the instructions provided with the forms to ensure you understand the requirements and properly complete them.
3. Fill out the forms accurately and completely. Double-check all information before submitting to avoid any delays or issues with the enrollment process. Pay close attention to any fields marked as mandatory or requiring specific formatting. It's essential to provide honest and up-to-date information to ensure accurate provider enrollment.
4. Attach any required supporting documents, such as copies of licenses, certifications, or professional liability insurance. Ensure that all attached documents are legible and relevant to your enrollment.
5. Once you have completed the forms and attached the necessary documents, submit your enrollment application. Review the submission process specified by HMSA to ensure you have followed the correct procedure. Some providers may need to submit their application physically, while others might allow electronic submissions.

Who needs HMSA provider enrollment and?

1. Healthcare providers: Healthcare providers, such as doctors, physicians, hospitals, clinics, and other medical professionals, need to complete HMSA provider enrollment to become part of the HMSA network. This allows them to provide services and receive payment from HMSA-insured patients.
2. Allied health professionals: Allied health professionals, including nurses, therapists, psychologists, and social workers, also need to enroll with HMSA if they wish to provide services to HMSA members. This enrollment ensures that HMSA members can access a comprehensive network of healthcare providers.
3. Ancillary service providers: Ancillary service providers like laboratories, medical imaging centers, pharmacies, and durable medical equipment suppliers also require HMSA provider enrollment to facilitate their collaboration with HMSA-insured individuals. Being an enrolled provider improves access to services and streamlines the billing process.
4. Facilities and institutions: Facilities and institutions, such as hospitals, medical centers, nursing homes, and rehabilitation facilities, need to complete HMSA provider enrollment to participate in the HMSA network. This allows them to admit and treat HMSA members, coordinating necessary care and services seamlessly.

Note: The specific requirements and enrollment process may vary depending on the type of provider and the specific contract or agreement with HMSA. It is recommended to contact HMSA directly or visit their website for accurate instructions tailored to your specific situation.

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What is hmsa provider enrollment and?

HMSA provider enrollment is the process of healthcare providers registering with the Hawaii Medical Service Association to become part of their network.

Who is required to file hmsa provider enrollment and?

Healthcare providers who wish to be part of the Hawaii Medical Service Association network are required to file HMSA provider enrollment.

How to fill out hmsa provider enrollment and?

HMSA provider enrollment can be filled out online through the HMSA website by providing the necessary information and documentation.

What is the purpose of hmsa provider enrollment and?

The purpose of HMSA provider enrollment is to create a network of healthcare providers that are affiliated with the Hawaii Medical Service Association to provide services to members.

What information must be reported on hmsa provider enrollment and?

Information such as provider credentials, contact information, practice location, specialty, and billing details may need to be reported on HMSA provider enrollment.