Customer ReviewsforHawaii Medical Service Association

HMSA has the entire market in Hawaii. Because of this, there is little accountability to pay physicians in a timely and accurate manner. Recently they outsourced all of the claims overseas. These representatives are not trained throroughly and it seems they still don't have enough people to process claims. They pay claims inaccurately over and over again, and there is absolutely NO recourse for physicians. If physicians choose to not participate, they can say goodbye to their livelihood. Simply stated, HMSA does not perform well because they DON'T have to perform well as there is ZERO competition. They don't care, they don't have to care and there seems to be little accountability from any one in key decision making positions. The president recently scored a HUGE bonus while his company may save a few dollars by delivering unacceptable service to the providers that care for their members. If providers delivered the same service they receive from HMSA to HMSA's members, people would DIE faster than I can finish this review. Simply put, HMSA demands physicians deliver in a way that they do not deliver.

HMSA out-of-state claims has been a nightmare for all of 2022. I am still waiting on claims from over 6 months ago to be entered into their system, never mind processed or paid. I filed a claim in February 2022, it was paid in August only after multiple calls, emails, and excuses. Claims for May 2022 only showed as pending this month - January 2023, again after numerous calls, emails and excuses. Claims for ***** are not in the system, neither are claims for July-November. I even sent claim requests by certified mail in July to ensure they arrived. Those were apparently received, but then lost and not entered into the system at all, I had to resend via email. All customer ********************** reps have been kind and helpful to the extent of their ability. The problem is at a level above just the person you speak to on the phone. I used to have a very favorable opinion and good experiences with this insurance company, even when out of state. Now, after this ordeal, I cannot recommend their services to anyone in good conscience. I was told it was a staffing issue but I find that hard to believe after nearly a year. Wholly unacceptable. If we did not pay our premium for 6-9 months, would we still be members? Not for long I'm sure. So why is this length of delay in even acknowledging and addressing claims acceptable? Short answer - it's not. Would give zero stars if possible.