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Plan Publications

Find any publications and information that AlohaCare has available to you.


  1. QUEST Integration Provider Manual
  2. Medicare Provider Manual
  3. QUEST Integration Provider & Pharmacy Directory´╗┐
  4. QUEST Integration Benefits
  5. Provider Quick Reference Guide
  6. QUEST Integration Primary Billing Payer Sheet
  7. QUEST Integration Secondary Billing OPAP Payer Sheet
  8. QUEST Integration Secondary Billing OPPR Payer Sheet
  9. Provider Enhancement Program


2022 Provider Advisories

January: Inappropriate Use of Ivermectin for COVID-19

January: Electronic Prior Authorizations (ePA)

January: FDA requires warning about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions

February: Tips for Prior Authorizations (PA) Submission for Pharmacy Benefits

February: New AlohaCare E-Consult (Curbside Consult) Program for QUEST Integration for PCPS (MD, PA, APRN) and Specialists (MD, DO)

March: Warning About Potential Abuse of Ioperamide (Imodium) 

March: FDA investigating possible increased risk of death with lymphoma medicine Ukoniq (umbralisib) 

March: Buprenorphine sublingual usage associated with dental problems

June: AlohaCare APR DRG Billing Guide

July: FDA warns about possible increased risk of death and serious side effects with cancer drug Copiktra (duvelisib)

July: FDA approval of lymphoma medicine Ukoniq (umbralisib) is withdrawn due to safety concerns

October: Transmucosal Immediate Release Fentanyl (TIRF)´╗┐

November: IngenioRx will become CarelonRx on January 1, 2023

2021 Provider Advisories

January: Acupuncture

January: Hawaii's Vaccination Plan

January:  Medicaid Eligibility For Freely Associated States Under The Compact Of Free Association (COFA) Citizens

February: COVID-19 Pandemic-Related Flexibilities Offered by Med-QUEST

February: Non-Emergent Medical Transportation (NEMT) Scheduling Transitioning To IntelliRide - Updated: 3/24/21

April: Community Care Foster Family Home (CCFFH) and Expanded Adult Residential Care Home (EARCH) - IMPORTANT CLAIMS SUBMISSION UPDATES

April: FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later

April: Studies show increased risk of heart rhythm problems with seizure and mental health medicine (Lamictal) in patients with heart disease

April: FDA warns about serious problems with high doses of the allergy medicine Benadryl

May:  New Pharmacy Benefits Manager - IngenioRx (beginning 7/1/2021)

June: REMINDER: New Pharmacy Benefits Manager - IngenioRx (beginning 7/1/2021)

July: REMINDER: Provider Relief Fund Post-payment Reporting Requirements

July: FDA restricts use of Ocaliva in PBC patients with advanced cirrhosis 

July: FDA warns that abuse and misuse of the nasal decongestant propylhexedrine causes serious harm

July: FDA requests removal of strongest warning against cholesterol-lowering statins during pregnancy

September: Prior Authorization Changes for Specific Durable Medical Equipment (DME)

October: Buprenorphine for Chronic Pain

October:  Safe Opioid Prescribing Practices

December: Important New PBM Implementation - Update

Pharmacy Communications

March: 100 Days Supply Coverage for Medicare Maintenance Drugs

May: Diabetic Testing Supplies

June: New Implementation - IngenioRx and CVS Caremark

September: Important Information for Claims Processing

September: Coordination of Benefits Change

November: Medicare 2022 Formulary Impacts & Walgreens Added to QUEST Pharmacy Network

December: CVS Caremark to process claims for AlohaCare Advantage Plus (HMO SNP)

December: Important New PBM Implementation - Update

2020 Provider Advisories

March: Important COVID-19 Notification

April: New Boxed Warning: montelukast (Singulair) and Mental Health Side Effects

April: Updated List of Covered Telehealth Services and Other Important Notifications Related to COVID-19

May: Medicare Quality Measures: CMS Part D Star Ratings

July: COVID-19: Nebulizer Use During the Pandemic

July: Prior Authorizations

July: CARES Act Provider Relief Fund

August: CARES Act Provider Relief Fund Application Deadline Extended!

September: Drug Management Program, a Pharmacy Home & Designated Prescriber for Opioid Therapy

September: Medication Adherence & Statin Use in Diabetics -- a Member Outreach Campaign

September: Opioid Utilization & Morphine Milligram Equivalents (MME)

October: 2020 Annual Plan Change Information for Providers

October: COVID-19 Public Health Emergency Extended

October: Non-Emergent Medical Transportation

November: Prior Authorization Changes

December: AlohaCare Substance Abuse Prior Authorization Changes

December: Electronic Visit Verification (EVV) Implementation Clarifying Information

2019 Provider Advisories

March: Update on Adaptive Behavior Services

May: Medicare Advantage and QUEST Integration Reimbursement Guidelines for LMFT and LMHC
Behavioral Health Providers

June: Changes to Prior Authorization List

June: Asthma Management & Albuterol Quantity Limits

July: Diabetic Testing Supplies

August: Electronic Prior Authorization (ePA) for Medicare (AlohaCare Advantage Plus)

August: Accredo Specialty Pharmacy

September: Implementation of Patient Driven Payment Model (PDPM) and
Patient Driven Groupings Model (PDGM)

September: FDA Warns About Serious Liver Injury with Some Hepatitis C Medicines

September: FDA Adds Warning for Certain Insomnia Medicines

October: New Morphine Milligram Equivalents

October: Our Care Our Choice Act

December: FDA warns about rare but severe lung inflammation with Ibrance, Kisquali, and Verzenio for breast cancer

December: FDA identifies harm reported from sudden discontinuation of opioid pain medicines

December: CDC Guideline for Prescribing Opioids for Chronic Pain

December: FDA approves Boxed Warning about increased risk of blood clots with higher does of arthritis and ulcerative colitis medicine tofacitinib (Xeljanz, Xeljanz XR)

December: FDA adds Boxed Warning for increased risk of death with gout medicine Uloric (febuxostat)

December: Opioids and Benzodiazepines

2018 Provider Advisories

June: PT/OT Prior Authorization Policy

2017 Provider Advisories

July: Change in Referral Policy

October: Change in Prior Authorization Policy

November: Flu Vaccine and Colorectal Screenings

2016 Provider Advisories

     2. May: AlohaCare National Drug Codes Billing Requirements
     3. October: Unlicensed Behavioral Health Providers in FQHCs and RHCs

2015 Provider Advisories

July: ICD-10 Transition

September: ICD-10 Claims

2014 Provider Advisories




AlohaCare Advantage (HMO) Medicare Health Plan

Provider Education Session (Hilo)




CMS 1500 Claim Form

Provider Newsletters

Quarter 3 2022

Quarter 2 2022

Quarter 1 2022

Quarter 4 2021

Quarter 3 2021

Quarter 2 2021

Quarter 1 2021

Quarter 3 2020

Quarter 2 2020

Quarter 4 2019

Quarter 3 2019

Quarter 2 2019

Quarter 1 2019

Quarter 4 2018

Quarter 3 2018

Quarter 2 2018

Quarter 1 2018

Quarter 4 2017

Quarter 3 2017

Quarter 2 2017

Quarter 1 2017




Provider Quick Reference Treatment Guides