Information

Title Appealing Processed Claims

Content

If a provider has questions about how a claim was processed, how it was paid, or why it was not paid, he or she may ask that the claim be reviewed. Requests for review must be made within one year of the provider's receipt of HMSA's original decision to deny or pay the claim. Below are options available to providers if they would like their claim reviewed.

Physician Appeals

Non-physician Appeals

Medicare Advantage Provider Appeals

Other Links

HMSA Akamai Advantage^® Non-Contracted Provider Appeals

HMSA Akamai Advantage Frequently Asked Questions (FAQs)

Akamai Advantage Non-Contracted Provider Appeal and Payment Dispute Request Form

Akamai Advantage Non-Contracted Provider Waiver of Liability Statement

HMSA Akamai Advantage^® is a PPO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage depends on contract renewal.

Change History

Rev#:	Date:	Nature of Change:
	01/21/2010	First Published
2.0	03/12/2009	This document replaces the previous version.
2.1	01/13/2011	Added links section at the bottom of the page.
2.2	01/24/2017	Updated the link to Akamai Advantage Non-Contracted Provider Appeals.
2.3	10/03/2017	Replaced obsoleted 65C Plus Provider Appeals link with link to new Medicare Advantage Provider Appeals page.
2.4	12/21/2017	Updated Akamai Advantage to HMSA Akamai Advantage where applicable and removed inactive 65C Plus links.
2.5	05/13/2021	The current source documents have been moved to a new document repository and links have been updated. Relevant files will remain attached to this article until they are updated with a new version. AA_Non-Contracted_Provider_Waiver_of_Liability_Statement AA_Non-Contracted_Provider_Appeal_and_Payment_Dispute_Request_Form AA_FAQs_Non-contracted_Provider_Appeal_and_Payment_Dispute_Process(1)
3.0	02/02/2024	The following disclosure statement has been added: HMSA Akamai Advantage® is a PPO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage depends on contract renewal.

Details

URL Name Appealing-Processed-Claims