Hmaa prior authorization form 2025

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  1. Click ‘Get Form’ to open the hmaa prior authorization form in our platform's editor.
  2. Begin by entering the date at the top of the form. This is essential for tracking your request.
  3. Fill in the 'Requesting Physician's Name' and their contact information, including phone number and fax number, ensuring accurate communication.
  4. Provide patient details: enter the patient's name, date of birth, sex, and member ID number. This information is crucial for identifying the patient within the system.
  5. In the 'Diagnosis' section, input relevant ICD-9 codes along with a description to clarify the medical necessity.
  6. List requested services using CPT/HCPCS/NDC codes and provide descriptions for each service needed.
  7. Include anticipated dates of service and any pertinent clinical information that supports your request. Attach supporting documentation as necessary.
  8. Finally, ensure that all fields are completed accurately before submitting your form through our platform for processing.

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HWMG administers health plans for self-funded and fully insured clients including Hawaii Medical Assurance Association (HMAA), and provides their members with network access. From time to time, HWMG may need to update the information in this manual.
Our member organizations include AlohaCare, Hawaii Medical Assurance Association (HMAA), Hawaii Medical Service Association (HMSA), Hawaii Western Management Group (HWMG), Humana, Kaiser Permanente, MDX Hawaii, 'Ohana Health Plan, UnitedHealthcare (UHC), and UHA Health Insurance (UHA).
HMAA is proud to be the exclusive PPO Association Health Plan offering for BIA-Hawaii providing access to affordable healthcare benefits for employees and families of BIA-Hawaii members. The BIA-HMAA Health Insurance Partnership is a benefit program created for members of BIA-Hawaii.
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For more than 30 years, HMAA has been providing quality group health insurance backed by superior service to thousands of businesses of all sizes throughout Hawai`i. We understand the local business environment and are dedicated to serving our clients with personalized care.

hmaa prior authorization