QUEST Integration – Quick Reference Guide

Original Effective Date:

04/01/1999

Current Effective Date:

01/01/2015

For most requests, providers and their staff may call or fax HMSA at the numbers listed in the HMSA Directory in this section. However, when you need to write us or submit claims or refunds by mail, you may use the contact information found in the links below.

To:	See:
Ask HMSA to reconsider a claim. Verify benefits. Register a referral. Authorize an agent to submit claims on your behalf.	HMSA QUEST Integration Provider Services
Make changes to your provider record such as: Changing your contractual status. Adding a location.	Provider Data Administration
Precertify benefits for: Procedures for which precertification is required (e.g., MRI or home IV therapy). A surgery, therapy, medically necessary cosmetic procedure or surgery, or procedure that employs new technology. A treatment location more intensive than is standard (e.g., hospital vs. physician’s office). Confinements that exceed guidelines for length of stay.	Precertification Unit
Register behavioral health or substance abuse cases.	HMSA’s Behavioral Health Services QUEST Integration (Carelon Behavioral Health^SM)
Request waiver of the claim filing deadline.	Send request with documentation of follow-up to HMSA – QUEST Integration Operations, Attn: Supervisor.
Submit claims for The HMSA Plan for QUEST Integration Members.	HMSA – QUEST Integration Operations
Reimburse The HMSA Plan for QUEST Integration Members for an overpayment or duplicate payment.	Mail your check payable to HMSA to HMSA – QUEST Integration Operations

CURRENT AS OF 08/03/2026

Revision History

Date	Nature of Revision
08/03/2026	Migrated to new platform.