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Before you start

Use this guide when HMSA is a required Local / Host Plan for your practice or claim-service location. Its nonparticipating application establishes a provider record without joining the network. An incomplete registration can delay claims. Not sure whether HMSA is the right plan? First identify your required Local / Host Plan.

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Open the professional-provider application

1

Choose nonparticipating enrollment

Open Apply To HMSA. Select Provider Enrollment Application, then Nonparticipating Provider, then Individual Application.Do not select Facility or Long-Term Services & Support just because you have a group of clinicians.
2

Complete the clinician and contact information

Enter the clinician’s actual identity, individual NPI, professional title, and specialty, plus the person HMSA can contact about the application.The Current Medicare CMS Status question is about the clinician’s Medicare status, not HMSA participation. Answer it accurately; do not choose Medicare Nonparticipating solely because this is an out-of-network HMSA application.
3

Prepare the requested documents

Have the IRS Letter 147C or W-9 ready as directed by the form. Complete Agent Authorization only if you are actually authorizing a billing agent or staff member to sign claims for the practice.The application gives document requests as you proceed and allows attachments at the end. Do not guess a Thrizer authorization or technical contact.
4

Confirm group associations when applicable

Your practice coordinates the clinicians’ records. Call 808-948-6330 or 800-790-4672 for Provider Services if you need instructions to establish the group billing record or link clinicians to it.A clinician application is not confirmation that a group record or every required affiliation is complete.
5

Review and track the application

Complete the required sections, review the information, and submit when ready. Keep the application information. The entry page offers Resume Enrollment and Check Application Status for follow-up.

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If a requirement is unclear

Ask HMSA Provider Services before signing or submitting. A specialty appearing in the form does not guarantee that HMSA recognizes every clinician at that license level or accepts the claim structure Thrizer supports. The form’s Medicare questions do not make Medicare or Medicare Advantage claims supported through Thrizer.

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What happens next

Once each required plan confirms registration and the required clinician associations are active, notify Thrizer support and review what happens next. The payer controls approval and reimbursement. For associate, pre-licensed, or supervised clinicians, confirm recognition with HMSA and review Thrizer’s supported claim structure.