Hawaii Blue Cross Blue Shield: HMSA
Please follow the Enrollment Instructions below to become an electronic submitter for Hawaii Blue Cross Blue Shield HMSA.
Required Documents for those applying for new Submitter IDs
The following documents are required enrollment documents that must be completed, signed and returned to the HMSA office prior to initiation of electronic claims submission or inquiry.
1. Electronic Trading Partner Agreement
If the above link does not work properly, please download the form from:
If you have any questions regarding any of the documents in this package, please call the HMSA EDI Technology Support Center at 1-800-377-4672.
We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.
Trading Partner Agreement
Please enter your Business/Practice or Provider Name in the first paragraph
Please complete the “Trading Partner” information required on page 14.
Exhibit A – Business Associate Authorization
Enter your Business/Practice or Provider Name, Address, and Signature
Under “Business Associate” please fill that section in again with your facility information including your phone number and the name of the billing contact for your office
Submitting your Forms
It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:
EMC/HHIN Support – Room 521
PO Box 860
Honolulu, HI 95808-0860
or Fax to 808-948-0860
It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.
Waiting for a Response
Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)
After processing, a confirmation will be faxed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the HMSA EDI Technology Support Center at 1-800-377-4672.
Once you have received your Submitter ID and Password from HMSA, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to HMSA.
Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.