The arbitration process is only available to providers who have a Participating Provider Agreement with HMSA. If you are dissatisfied with HMSA’s internal appeal decision and wish to pursue the matter further, you must request arbitration within 60 calendar days of the date of the internal appeal decision, except if you are a TRICARE provider and your appeal relates to services provided to a TRICARE beneficiary, you have 120 days from certain events described in your TRICARE contract.
The arbitration request must be in writing and sent to:
HMSA--Legal Services
P.O. Box 860
Honolulu, HI 96808-0860
Additional information:
- You must exhaust any internal appeals prior to requesting arbitration
- The decision of the arbitrator is final and binding.
Please refer to your Participating Provider Agreement for more details concerning arbitration requests.
For TRICARE providers, please refer to your TRICARE Individual Practitioner Contract for more details concerning dispute resolution and arbitration.
LS: August 2011
