AlohaCare provides comprehensive medical and prescription drug coverage through a statewide network of contracted physicians and providers. Our network has nearly 3,000 providers to care for our members. AlohaCare’s network includes a broad range of PCPs, specialists, facility, ancillary and other providers through which members can access the full range of benefits.
A key component of our relationship with our providers is centered on our responsibility to be a good partner. With our vision of partnership, we are committed to the delivery of timely and medically-appropriate health care to our members
You may contact our Provider Relations Call Center at 973-1650 or toll-free at 1-800-434-1002 or submit your inquiry via our online Contact Us form if you have any questions.
Interim CEO's Letter to Providers
June 4, 2020
Aloha, valued Providers:
I hope that this letter finds you in good health and spirits. You may have already heard that AlohaCare’s Board of Directors appointed me to serve as AlohaCare’s Interim CEO in late March. I’m grateful for the trust placed in me to lead this treasured organization during a particularly difficult time.
First, I would like to thank you for caring for AlohaCare’s members to the best of your abilities during this trying time. We are incredibly proud of the dedication and resilience shown by our Providers during this pandemic. Knowing the risks and threats to your own personal safety, we witnessed and experienced tremendous acts of selflessness, bravery, kindness and caring among the provider community. Since the emergence of the pandemic, you and your staff adapted to new ways of working to mitigate the impacts of COVID-19, while focusing on the safety and well-being of your patients. We also recognize that some providers were forced to reduce office hours, or close your practice temporarily; please let us know how we can help you get back to serving patients. We updated you on changes in the use of telehealth services to expand your ability to provide needed medical care and timely advice to your patients. We are interested in hearing from providers who are thinking of expanding telehealth services or would like explore other opportunities. We increased our member communications by phone and through text messages, to let our members know we are here to support them. We offer these resources to help you re-start your practices. We are happy to assist in any way we can.
AlohaCare is a strong health plan with a strong commitment. We are ingrained in our communities and will continue to uphold our mission and vision as a local health plan, with local roots, serving the healthcare needs of Hawai’i citizens. On May 29, 2020, the Department of Human Services Med-QUEST Division (MQD) announced that it would rescind the recent QUEST Integration RFP outcome and extend the current contracts for all Hawaii Medicaid health plans to 2021. We are thankful that AlohaCare will continue to serve our members on all islands into 2021. As we plan for the future, we will work closely with the MQD to administer the QUEST Integration program on a statewide basis.
I have great confidence in the leadership, organizational assets, and health plan operations that support AlohaCare’s success. Our recently completed regulatory financial audit showed that we are on solid financial footing. Operationally, we have transitioned the majority of our employees to work from home with a few critical staff working in the Honolulu office. Through online communication and our staff’s work ethic, we quickly adapted and continued our services uninterrupted. We are responsive and proactive in meeting the needs of our members, staff and our Providers. A great example of this is our Chief Medical Officer, Dr. Gary Okamoto, who worked with AlohaCare member, Fala Letina, and his oncologist, Dr. Galen Choy, to secure out-of-state treatment for Fala. Fala’s story can be viewed here -- https://www.hawaiinewsnow.com/2020/05/08/international-effort-underway-unite-siblings-bone-marrow-transplant/
The AlohaCare team is committed to working collaboratively with you to continue to support the delivery of excellent care for our 65,000 members across the continuum of medical, behavioral health and dental benefits offered by AlohaCare’s QUEST Integration and Medicare Special Needs Plans. We will weather this public health crisis together and emerge stronger and even more connected as a community. Your invaluable service and valued voice will help to implement changes that will support and improve how we collectively work together towards common goals. Ensuring prompt and timely payments to Providers will remain one of our top priorities because we know that consistent and reliable revenue flow is important to any business. We will do our best to be a trusted partner; however, if something did not go well despite our best efforts, please feel free to contact Call Center at (808) 973-1650 or toll-free at 1-800-434-1002, or contact our county-based Provider Services Representatives who are listed below. We would appreciate the opportunity to make it right.
- Hawaii County – Marada Terry, (808) 934-7561, firstname.lastname@example.org
- Kauai County – Brennan Carroll, (808) 482-2921, email@example.com
- Maui County – Bianca Whyte, (808) 856-2296, firstname.lastname@example.org
- Oahu – Malia Garza, (808) 973- 0828, email@example.com or Tory Tanaka, (808) 973-0459, mailto:firstname.lastname@example.org
In closing, although my preference would have been to meet and thank you in person, local, national and international COVID trends remind us that we must continue to take precautions to keep Hawaii safe from this pandemic. I hope that in the months to come, and as conditions improve, our team and I will have the opportunity to personally thank you.
On behalf of all of us at AlohaCare, Mahalo for partnering with us to care for our members.
Summary of Updated AlohaCare Provider Advisory Relating to COVID-19
Telehealth Services: AlohaCare is providing an updated Provider Advisory that contains the most recent guidance from CMS and the Med-QUEST Division (MQD) regarding coverage for telehealth and telecommunication services you can furnish to your AlohaCare Medicare and QUEST Integration patients during the COVID-19 public health emergency (PHE). We continue to closely monitor and vet information and guidance issued by CMS and Hawaii DHS to inform you as quickly as possible of any changes to our policies and processes, particularly those that allow a temporary expansion of covered services or relaxation of current government mandates (such as HIPAA requirements), that promote the delivery of timely care.
Disbursement of CARES Funds: Hawaii providers can expect to receive federal relief funds from the Coronavirus Aid, Relief, and Economic Security (CARES) Act in response to the COVID-19 emergency. Payment distribution is expected to begin on April 10, 2020.
Medicare Sequestration Update: Due to the public health emergency, effective May, 1, 2020, CMS will temporarily stop the 2% Medicare payment withholds referred to as sequestration.
All Provider Advisories will be posted within the Plan Publications tab of the Provider section of this website.
Electronic Visit Verification (EVV)
The Med-QUEST Division of the Hawaii Department of Human Services is implementing an Electronic Visit Verification (EVV) system to fulfill new federal requirements.
EVV eliminates the need for paper documents and enhances efficiency and transparency of services through quick electronic billing. It also offers flexibility for appointments and services as well as reducing the gaps in care for missed, late, or incomplete visits.
Click here for more information about EVV: https://medquest.hawaii.gov/en/about/recent-news/2018/electronic-visit-verification.html
ACCREDO SPECIALTY PHARMACY
Accredo, an Express Scripts specialty pharmacy, opened a new location in Honolulu to serve members living with complex conditions. The new pharmacy offers a range of services, including walk-in consultations with a pharmacist, courier and mail order delivery and a site-of-care (or ambulatory) infusion center with on-site nurses. Oncology treatments and intravenous immunoglobulin are among the therapies administered on-site. The pharmacy is available to serve all residents of Hawaii whose pharmaceutical benefit includes Accredo.
AlohaCare is partnering with Accredo as its preferred specialty pharmacy to serve members living on Oahu, Kauai, Molokai, Lanai, Maui, and Hawaii Island. Accredo's unique model of care aligns with AlohaCare's goal of delivering high touch, patient-centered care. Together, AlohaCare and Accredo are committed to improving access to quality care for Hawaii, and AlohaCare is excited to offer increased opportunities for in-home care and delivery statewide.
Through its Therapeutic Resource Centers, Accredo provides specialized care for complex or chronic conditions, including cancer, pulmonary arterial hypertension, rheumatoid arthritis, and immune deficiencies.
Accredo can provide the level of care your patients on specialty drugs need, with services that include:
- The broadest access to exclusive and limited distribution drugs in the industry
- Safety program that helps prevent potentially harmful drug interactions
- Access to a team of pharmacists and nurses who have received specialized training in your patients' medical conditions
- Registered nurses available for in-home medication administration, when clinically appropriate and as their plan allows
- Scheduled delivery to your patients' homes or your office (where allowable by law) -- at no additional charge
- Patient refill reminders and proactive prior authorization renewals
For specialty medications, please submit your prior authorization request through AlohaCare and submit a prescription to Accredo via one of the following options:
- Send new prescriptions to Accredo by e-prescribing or visit accredo.com for instructions
- Fax new prescriptions to Accredo at 800-391-9707
- Call in new prescriptions to Accredo at 808-650-6596 or 877-852-7247
To learn more about Accredo services, the medications they dispense and how to get your patients started, visit www.accredo.com.