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Regence Blue Cross Blue Shield of Oregon
Oregon state health insurance For Physicians, Other Health Care Professionals and Facilities

Healthcare Management Administrators

Additional employer group members may utilize our Participating and Preferred and Dental networks. 

These members are covered by self-funded health plans administered by Healthcare Management Administrators (HMA), a wholly owned subsidiary of Regence BlueShield (in Washington). HMA provides third-party administrative services to over 100 self-funded employer groups primarily located in Oregon and Washington.

These members may live in or travel to our service area and seek services from you. The HMA Preferred product uses the Regence BlueCross BlueShield of Oregon (Regence BCBSO) Participating and Preferred Provider Plan (PPP) networks as the provider network for their HMA Preferred product. Reimbursement is the same as Regence Participating and/or Preferred Provider Plan networks.

Identifying members
The front of the member cards include the:

  • HMA logo (on some cards, the name of the sponsoring employer will appear instead)
  • HMA Preferred Network logo, shown in the upper right corner of the member card

The back of the member card indicates that the HMA Preferred Network is a combination of the Regence (Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield) and Asuris Northwest Health networks.

HMA Member Card

Obtaining pre-authorization, eligibility, claims status or answers to other inquires
Obtain this information by:

Notes:

  • HMA member information is not available in the Regence Provider Center.
  • Please contact HMA to obtain pre-authorization information for HMA members. HMA employer groups pre-authorization requirements differ from Regence. Self-funded plans typically have more stringent authorization requirements than those for fully-insured health plans.

Submitting claims to HMA
Submit claims to HMA electronically or via paper.

For electronic claims:

  • Submit claims directly to Availity® with Payor ID HMA01.
  • The claim should include the three-digit prefix and the subscriber number listed on the member's card.
  • Do not submit HMA claims to Regence. HMA claims that are submitted incorrectly to Regence will be returned with instructions to resubmit to the correct payer.

Mail paper claims to:

Healthcare Management Administrators, Inc.
P.O. Box 85008
Bellevue, WA 98015

Receiving vouchers and payment
Vouchers and reimbursement checks will be sent to you from HMA. The provider vouchers and member Explanation of Benefits (EOBs) will include a message code and description. Claims information and vouchers for your HMA patients are not available in the Regence Provider Center.

Message Code Description
DH HMA dental provider discount. The patient is not responsible for this amount.
RE Regence BlueShield provider discount

To have payments deposited directly into your bank account through electronic funds transfer (EFT), contact HMA's Customer Service department at 1 (800) 700-7153.

Questions

If you have any questions regarding HMA access to the Regence BCBSO Participating, Preferred and Dental networks, please contact your provider relations representative.