Improved access to claim information now available in My Account
HMSA’s My Account now offers a better way to view your in-state claims for most plans. The new Web tool allows you to:
- See a summary of your medical and vision services sorted by date of service.
- Sort claims by provider, date of service, status, and the amount you may owe.
- Search for specific claims.
- See whether claims are “processed” or “in process.”
To view the new claims tool in your My Account:
- Register and log on to My Account.
- Click on the “Claims” tab at the top left corner of the page or on “View Claims” at the right side of the page.
Claims labeled “in process” will not have detailed information, but will let you know the claim has been received.
Clicking on each claim will display the following details about how your services are paid:
- Total charge: The amount your provider billed for the service.
- HMSA Discount: The amount HMSA has negotiated with a provider on your behalf. Applied only when you use a participating HMSA provider.
- Eligible charge : The total amount eligible for payment to a participating provider.
- HMSA Paid: The amount HMSA paid you or your provider.
- You may owe: The amount you may owe the provider.
- Claim messages: If available, click on the More Info tab listed next to services to view additional messages. These include an explanation about why a service was denied. For example, Tax is the member’s responsibility is a common denial message.
If applicable, the detail screen may provide other information, such as the amount applied toward your plan’s annual deductible or payments made by other insurers.
If you currently receive Report to Member (RTM) statements online, you will continue to receive your RTMs in your My Account. The new tool will include convenient links to your RTMs.
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