HMAA & EDI

Claim Submission

All paper claims for healthcare services must be submitted on a properly completed ADA claim form. All paper claims should be mailed to:

HMAA
P.O. Box 32580
Honolulu, HI 96803

Fax Claims: (888) 292-3017 (Fax back confirmation reports available)

Electronic (EDI) Claims

• HMAA is able to accept claims via Electronic Data Interchange (EDI).
• HMAA is also able to accept digital x-rays (eAttachments) for delivery to HMAA and many other plans.
• HMAA’s EDI clearinghouse is Tesia Clearinghouse, LLC.
• HMAA’s Payer ID number is TFQ61 or TPC08.
• In order to submit claims via EDI through Tesia to HMAA, providers must first establish an account with Tesia or a designated partner of Tesia.
• Leading partners of Tesia include Renaissance Systems & Services (RSS), Dentrix, Practice Works, SoftDent, CareStream, Innova (Software Creations), First Pacific Corp, and many more.
• Tesia will electronically transmit your HMAA claims free of charge.
• To establish an account, contact Tesia at (800) 724-7240.
• To obtain a list of Tesia Payer ID numbers for other payers who accept EDI claims (many for free) visit www.Tesia.com.

Hints for Successful Claim Submissions

• HMAA may reject claims if the providers' Tax ID Number (TIN) is not in our system. Please verify that the TIN you are submitting is on file with HMAA. This is important for providers using multiple TINs.
• Submit EDI claims with the providers full and proper name and National Provider Identifier (NPI) number. To apply for an NPI number, go to https://cms.hhs.gov.
• Verify the Member health plan ID prior to transmission.
• Retain copies of your EDI transmission acceptance reports as evidence of transmission.
• If you have questions regarding electronic claims submissions, contact Tesia’s Services Representative at (800) 724-7240.
• Any claims requiring X-ray submission must be submitted using diagnostic quality images, with the approproate type of radiograph for review.

Paper Claims

• Be sure to properly complete your claim form. Any missing or omitted information may lead to a delay in processing or rejection of your claim.
• Always include your Tax ID Number and NPI (National Provider Identification) number.
• If your claim has been inadvertently misrouted and, as a result, is being submitted after the allowable filing time has expired, please include proof of timely filing with your resubmitted claim.