HMSA
Welcome to the HMSA (Hawai'i Medical Service Association) Health Plan page. The documents below have been designed to help RadMD users navigates the prior authorization process for each program Evolent is responsible for. Additional process-specific training tools and modules can be found via links on the Resources tab at the top of the screen.
For assistance and questions related to your authorizations and Peer-to-Peers for all products, please contact the HMSA call center: 1-866-306-9729
For all RadMD, provider relations issues/questions and education needs: HMSAProviderConcerns@evolent.com.
Clinical Guidelines
- Advanced Imaging and Cardiac Clinical Guidelines - Effective April 1 Annually
- Hip, Knee, Shoulder Guidelines - Effective July 1 Annually
- Pain Management (IPM) Guidelines - Effective July 1 Annually
- Spine Surgery Guidelines - Effective July 1 Annually
- Physical Medical Guidelines - Effective July 1 Annually
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.
Advanced Imaging and Cardiac Program
- Cardiac Checklist
- Cardiac Frequently Asked Questions
- Cardiac Tip Sheet
- Checklist
- Clinical Fast Pass / Limited Fast Pass
- Frequently Asked Questions
- MPI vs. Stress Echo Tip Sheet
- Preauthorization Process for Clinically Urgent Requests
- Provider Education Presentation
- Quick Reference Guide
- Tip Sheet
- Tip Sheet for Pediatrics
Helpful Education Documents by Program
Interventional Pain Management Program
Musculoskeletal Program
- Checklist - Hip, Knee and Shoulder
- Checklist - Spine Surgery
- Frequently Asked Questions - Joint Surgery
- Frequently Asked Questions - Lumbar and Cervical Spine Surgery
- Provider Education Presentation - Hip, Knee and Shoulder Surgery
- Provider Education Presentation - Spine Surgery
- Quick Reference Guide - Joint Surgery
- Quick Reference Guide - Spine Surgery
- Tip Sheet - Hip and Knee Arthroplasty
- Tip Sheet - Hip and Knee Arthroplasty (Medicare)
- Tip Sheet - Knee Arthroscopy
- Tip Sheet - Shoulder Arthroplasty
- Tip Sheet - Shoulder Arthroscopy
- Tip Sheet - Surgeries Not Managed