Claims & Billing
Explore claims and billing resources, including filing requirements, payment guidelines, and coverage information.
Billing for Injectable Drugs (Non-Vaccines)
Learn HMSA billing guidelines for injectable drugs (non-vaccines), including HCPCS and NDC coding, claim submission requirements, and provider-specific instructions.
Billing HMSA for Immunizations
Learn HMSA billing guidelines for immunizations, including coding requirements, claim submission details, and reimbursement information.
Claims - Skilled Nursing Facilities
Learn billing guidelines for skilled nursing facility claims, including UB‑04 requirements, per diem services, CPT and revenue code usage, and Medicare coordination.
Claims Filing Highlights - Vision
Review vision claims filing highlights, including key billing guidelines, submission requirements, and best practices for accurate and timely reimbursement.
Claims Filing Workflow
Guidelines for claims filing workflow, including submission steps, required documentation, and processes by payer type and coverage scenarios.
Codes That Do Not Meet Payment Determination Criteria
Learn about codes that do not meet payment determination criteria, including noncovered services, billing limitations, and compliance guidelines.
Coding Guidelines for Medical Nutrition Therapy (MNT)
Learn about coding guidelines for medical nutrition therapy, including CPT codes, documentation requirements, and billing practices for claims accuracy.
Collection and Handling - Vision
Review guidelines for the collection and handling of vision care materials, including proper procedures, safety practices, and compliance requirements for accurate results.
Continuous Glucose Monitoring System – Coding Guidelines (Effective 02-01-2022)
Learn about continuous glucose monitoring (CGM) system coding guidelines, including billing requirements, HCPCS codes, and documentation for accurate claims processing.
Contraceptive Services
Guidelines for contraceptive services, including coverage, eligible services, and requirements under HMSA plans.