Patient Advocates for Hawaii Medical Service Association - Find one today.
Supporting and empowering Hawaii Medical Service Association patients across the Aloha State.
Hawaii Medical Service Association has served Hawaii residents since 1938, but understanding their authorization protocols and appeal structure can feel like navigating island channels without a local guide. Your Solace advocate understands the specifics of HMSA policies—from securing prior approvals to challenging claim denials and coordinating specialty care across their island networks. They'll organize the paperwork burden, manage the follow-up calls, and clear the administrative barriers so you can focus on your health instead of struggling with insurance requirements.
Best of all, most patients pay nothing out of pocket.
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About
Hawaii Medical Service Association stands as the largest health insurance provider in Hawaii, serving about 700,000 members across the islands. With Hawaiian roots dating back to 1938, HMSA offers various health insurance plans including Preferred Provider, Health Maintenance, QUEST Integration, and Medicare Advantage options through their island-specific provider networks. While they provide access to healthcare facilities throughout Hawaii and connections to mainland providers through the BlueCard program, members face challenges with their island-specific authorization requirements and structured appeal process. Their prior approval system requires precise documentation and timing, with members tracking authorization status through the My Account portal. For appeals, HMSA follows a multi-stage review process that reflects Hawaii insurance regulations, creating barriers for members contesting denied claims or services.
What problems can a Hawaii Medical Service Association patient advocate help you with?
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Get the clarity you need to make sense of your care and take charge of your health.
We’ll make the calls (and the callbacks) so you can spend more time doing what you love.
Keep your care affordable with lower medical bills and access to local financial help.
Advocates review coverage, handle preauthorizations, and even help with appeals.
Stay on top of the cutting-edge treatment options and leave no stone unturned.
Advocates coordinate your care team so your health never falls through the cracks.
Get the tools and answers you need to make informed decisions about your care.
Advocates help you overcome your healthcare hurdles—no matter how big they might be.
Solace has helped over 14,000 patients and families
Rose G.
04/01/2024
Eric H.
08/07/2024
Joan H.
05/01/2024
Stephen I.
04/27/2024
Jonathan J.
06/05/2024
Anne J.
07/27/2024
Hawaii Medical Service Association Appeals with a Patient Advocate
Handling HMSA's appeal system requires expert knowledge of their specific procedures. HMSA maintains a structured process with distinct phases—using specific forms, submission methods, and review timelines that challenge many patients. Your Solace advocate crafts effective appeals that meet HMSA standards, collects vital medical documentation, and presents your case using terms that align with their review criteria. They track submission deadlines and guide your appeal through the proper channels, whether you need an internal review or must advance to an external review through the Hawaii Insurance Division.
Beyond appeals, your Solace advocate functions as your guide through the entire HMSA system. They help you secure necessary approvals before procedures to prevent denials, explain how to maximize your benefits within their island networks, and coordinate communication between your healthcare providers and HMSA review teams. When facing network limitations, they help you find in-network specialists or request exceptions for off-island care when medical necessity exists. They also interpret your benefits package to discover hidden coverage options, from preventive services to programs for chronic conditions. In every interaction, they transform insurance jargon into plain language so you can make informed health decisions.
Your Solace advocate slices through Hawaii Medical Service Association's administrative maze, capturing the benefits you've paid for and rightfully deserve.
The Solace care team model
With Solace, you get both a patient advocate and a supporting physician, which we refer to as your “care team”.
Your advocate will be there to manage the day to day aspects of your care: coordinating with doctors, researching potential solutions and communicating updates to you.
Your supporting physician can unlock resources for you and your advocate that might otherwise be out of reach.
We’ve Got Answers
Still unsure how an advocate can help? Explore these answers to the questions we’re asked the most.
How are Solace advocates qualified to help?
Advocates on Solace are experienced physicians, nurses, pharmacists, and other healthcare professionals from a wide range of backgrounds. 98% of Solace patients report better healthcare outcomes after working with an advocate.
What else can a Solace advocate help me with?
What can a Solace advocate not do?
We know our advocates sound like miracle workers, but they have limits. They can’t prescribe medications or diagnose an illness, for instance. They can’t replace your doctor, but they can break down the barriers standing between you and the quality care you deserve.