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 Pharmacy Payer Sheet


2021 Provider Advisories

Jan. 29: Acupuncture

Jan. 30: Hawaii's Vaccination Plan

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

Feb. 4: COVID-19 Pandemic-Related Flexibilities Offered by Med-QUEST

Feb. 12: Non-Emergent Medical Transportation (NEMT) Scheduling Transitioning To IntelliRide - Updated: 3/24/21

April 16: 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 4:  New Pharmacy Benefits Manager - IngenioRx (beginning 7/1/2021)

June 15: REMINDER: New Pharmacy Benefits Manager - IngenioRx (beginning 7/1/2021)

July 12: 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

Sept 1: Prior Authorization Changes for Specific Durable Medical Equipment (DME)

Pharmacy Communications

March 23: 100 Days Supply Coverage for Medicare Maintenance Drugs

May 7: Diabetic Testing Supplies

June 1: New Implementation - IngenioRx and CVS Caremark

Sept. 9: Important Information for Claims Processing

2020 Provider Advisories

March 20 (11:20 a.m.): 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

2020 APC Provider Fact Sheet

2020 APC Provider Office Flyer

2020 APC Provider Regulations

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 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