Frequently Asked Questions
HMAA's Electronic Data Interchange (EDI)
HMAA's Electronic Data Interchange (EDI)
- Which clearinghouse does HMAA use?
- How do I contact Claimsnet?
- Does HMAA accept claims directly via website?
- What if I am already sending claims through Claimsnet for other payers?
- What if I am already sending claims to another clearinghouse?
- What types of electronic claim formats do HMAA accept?
- How can I be sure that HMAA is receiving our claims?
- Why is HMAA not receiving our claims transmission?
- Why is HMAA receiving paper claims from us when we transmit electronically?
- Should I submit the same claims electronically AND by paper just to be sure they are received?
- Does HMAA provide Electronic Remittance Advice (ERA)?
- Which clearinghouse does HMAA use?
HMAA uses Claimsnet as its EDI clearinghouse, payor ID 48330. - How do I contact Claimsnet?
You can call Claimsnet toll-free at (800) 356-0092 or go to their website at www.claimsnet.com/HMAA to register. - Does HMAA accept claims directly via website?
In some cases, HMAA may accept direct submission of electronic claims. Please contact HMAA to discuss transmittal options. - What if I am already sending claims through Claimsnet for other payers?
If you already are sending claims through Claimsnet for other payers, you do not need to contact Claimsnet. Just begin submitting HMAA claims electronically following Claimsnet’s guidelines.
If you are NOT currently submitting claims through Claimsnet for other payers, you or your billing vendor will need to establish a connection for electronic submission with Claimsnet. You can contact Claimsnet toll-free at (800) 356-0092 or you can go to www.claimsnet.com/HMAA to register. - What if I am already sending claims to another clearinghouse?
If you currently use a clearinghouse for electronic submission of claims to other payers, you may be able to submit HMAA claims through your existing relationship. Claimsnet accepts claims from Proxymed, Medavant, THIN, ENS, and several others. Please contact Claimsnet at (972) 458-1701 ext. 118, to determine if your current clearinghouse may be utilized for submission of electronic HMAA claims. - What types of electronic claim formats do HMAA accept?
HMAA will only accept EDI claims through the Claimsnet clearinghouse. - How can I be sure that HMAA is receiving our claims?
You should routinely review the confirmation and rejection reports supplied by your vendor and Claimsnet each time you transmit claims to HMAA. These reports should be used to compare your actual submission totals against the totals shown on the reports. They will confirm which claims have reached their destination and which claims were rejected. If you do not currently receive these reports or you are unsure of how to use them, please contact your vendor.
Regardless of your individual vendor, when you send a claim electronically to HMAA, it must be processed through Claimsnet. At Claimsnet, the claim goes through a set of standard edits to make sure the claim is error-free. If the claim meets these standard requirements, Claimsnet accepts the claim and forwards it to HMAA. If the claim is missing required information or does not meet Claimsnet’s edits, Claimsnet rejects the claim and the claim does not reach HMAA. - Why is HMAA not receiving our claims transmission?
This problem could result from many different causes. Please review the steps below to determine the most viable solution:
- Verify that all claims are transmitted to HMAA from both your vendor and Claimsnet by reviewing your confirmation/rejection reports daily
- Make certain all eligible claims in your system are flagged to go out electronically to Claimsnet using HMAA’s payer ID
- Check with your vendor to verify they are receiving all of your claims
- Ask your vendor to contact Claimsnet to verify that all of your claims are received by Claimsnet
- Some vendors require an additional number for electronic routing unique to their vendor requirements, or a reference regarding the actual payer address/name information passed to determine electronic routing. Please check with your vendor to determine vendor-specific edits for routing claims electronically to HMAA
- If all of the above has been checked and verified, but HMAA is still not receiving your claims, please contact HMAA’s Provider Services Department at (808) 591-0088 or toll-free at (800) 621-6998, or by e-mail at ProviderServices@hmaa.com
- Why is HMAA receiving paper claims from us when we transmit electronically?
Some vendors offer a service that automatically converts electronic claims to paper if they are rejected during transmission to the next vendor. Review your Claimsnet rejection reports and contact your vendor to discuss how they handle rejected claims. - Should I submit the same claims electronically AND by paper just to be sure they are received?
No. Please choose either paper OR electronic filing, not both. Filing twice, by paper and electronically, will result in duplicated claim handling by HMAA.
Note: This does not apply to specific requests by HMAA for paper claims with additional attachments that must be submitted by paper. - Does HMAA provide Electronic Remittance Advice (ERA)?
No. ERA is currently not available. Hardcopy remittances are sent to providers by mail.
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