Dental Provider Resource Center
Registration Timeline
The table below provides a general outline of the major steps involved in the participating provider registration process. For each action the provider must take, HMSA must execute a corresponding action.
It is important that the provider submit all required information completely and accurately, so that HMSA can begin the verification of the provider's credentials. The credentialing process itself typically takes 45 to 75 days and ends with the review of a provider's credentials by the HMSA Credentialing Commitee.
It is also important that the provider sign and promptly return the HMSA participating provider contracts for the programs requested. By the end of the process, the provider is registered as participating with HMSA's provider network and may receive direct payment for claims submitted for services rendered to HMSA members.
| Provider Action | HMSA Action |
|---|---|
| 1. Contact HMSA or visit HMSA's Provider Resource Center to learn about becoming a participating provider. | 2. HMSA sends you provider enrollment packet (or you may download forms from HMSA 's Provider Resource Center). |
| 3. Meet with HMSA Field Representative. | 4. Representative brings application packet to meeting and is prepared to answer any questions you might have about HMSA or provider enrollment process. |
|
5.* Review application packet. A. Complete and mail the following credentialing forms to HMSA:
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6. HMSA receives and reviews credentialing information and submits your application for credentialing. When HMSA receives the balance of your application, it will review and verify for accuracy. HMSA will contact you should any information be missing or incomplete. Provided all information is complete and verified accurate, HMSA mails you appropriate contracts. |
| 7.* Review participating provider contract(s) for line(s) of business in which you requested participation; sign and return contract(s) to HMSA within 14 days of receipt. | 8.* HMSA holds signed original until credentialing process is complete. Once HMSA makes a decision about your status within our provider network, you receive notice of your HMSA provider number, participating status and effective date of your enrollment as an HMSA provider. |
| 9. Submit claims for services rendered to HMSA members using your HMSA provider number. | 10. HMSA processes your claims according to HMSA established policies and procedures. |
*Notes
5. Please use the documentation checklist to help ensure your application is complete upon submission. Failure to submit all documentation and forms required to process your application will cause a delay.
7. Contracts not returned to HMSA within the specified time frame will result in a delay in processing your application, which may affect the effective date HMSA assigns to your participating provider agreement.
8. If HMSA's Credentialing Committee does not accept your application as a participating provider, you will be assigned a nonparticipating provider number, which you may use to submit claims for services rendered to HMSA members. Please contact your Field Representative for details about nonparticipation.
