HI Health Insurance Provider Newsletter - Spring 2017

View a preview of the Newsletter below or View the full UHA Newsletter "Better Health, Better Life" - Spring 2017



Message from the CEO

Employee Wellbeing—Addressing Mental Health in the Workplace

I’m honored to share that UHA has been nationally recognized by the American Psychological Association (APA) with a Psychologically Healthy Workplace Award.  The APA award is a testament to the impact that a culture of workplace wellness has had on our organization and can have on others.

At UHA, we see it as our responsibility, our kuleana, to support businesses in their pursuit of workplace cultures that encourage employee wellbeing. With respect to mental health, it’s common knowledge that a leading cause (if not the main cause) of stress is finances.  With stress proving to have such detrimental and devastating effects on overall health, we see financial wellbeing as a cornerstone of decreased stress and ultimately better health. 

The discussion on financial wellbeing will continue at the May 18th general meeting of UHA’s subsidiary, the Hawaii Health at Work Alliance ([email protected]), where Dr. Brad Klontz, Psy.D., is sharing his research findings on the psychology of financial wellness.  I’m also excited to share the findings of the first Hawaii Workplace Wellness Survey conducted by [email protected]—also featured at the May 18th annual meeting.

For event tickets and more information on the [email protected] May 18th event, visit: hhawa.com/events.

Howard Lee
UHA President & CEO

Provider Voice

Meet Dr. Kathy Kozak

Part-time UHA Medical Director, host of Hawaii Public Radio's "The Body Show"

Honolulu, HI (March 16, 2017) – Kathleen Kozak, M.D. has joined UHA as a part-time medical director, while continuing her practice as an internal medicine physician at Straub Clinic and Hospital.

As a UHA medical director, she will assist UHA members with access to quality health care services and work to ensure that these services are provided appropriately and consistently. She will serve on UHA’s Physician Advisory Panel as well as working closely with UHA providers and our in-house care management nurses.

Learn more about Dr. Kozak

Provider Agreement and Fee Schedule Renewal - Effective August 1, 2017

By now, you should have received the 2017 Provider Agreement and Fee Schedules (Exhibit IA and Exhibit IB). We ask that you return the signed Agreement to UHA via email to [email protected] prior to the effective date.

As a reminder, providers who have enrolled to receive EFT payments and access RA’s via UHA’s Online Provider Portal are eligible for the higher reimbursement rates shown in Exhibit IA.  Providers who are not registered for EFT and UHA’s Online Provider Services Portal are eligible for the reimbursement rates shown in Exhibit IB.

Please register for Electronic Funds Transfer (EFT) and UHA’s Online Provider Services Portal and become eligible for the higher reimbursement rates shown in Exhibit IA.

If you have not received a copy of the 2017 Provider Agreement and Fee Schedules (Exhibit IA and IB) and would like a copy, please contact UHA’s Contracting Services Department via email at [email protected].

Please submit your completed forms via fax to 1-866-572-4383 or via email to [email protected].

Onsite Flu Vaccinations

We are partnering with Express Scripts (ESI), our Pharmacy Benefit Manager (PBM) to administer onsite flu vaccinations for our employer groups.  ESI will be mailing out a Request for Proposal (RFP) to all participating pharmacies in the network to provide this valuable service to our employer groups in September for the 2017 to 2018 flu season. 

New Prior Authorization List

Please be on the lookout for the new Prior Authorization (PA) list effective June 1, 2017.   The PA list helps to identify which services require a prior authorization.  UHA’s Health Care Services Department will make a decision within 15 days of receipt of your request for prior authorization.  But if you submit your PAs via our handy online prior authorization tool, you will get an even quicker response to your requests.  Log onto the Provider Portal to view a quick “how to” video!

For more information, please contact our Health Care Services Department at (808) 532-4006 or Toll free at (800) 458-4600, ext. 300.

Do you have patients at risk for diabetes?

UHA is teaming up with the Hawaii State Department of Health (DOH) and YMCA to promote awareness of prediabetes in adults, and encouraging patients to talk to their health care providers about their risk for diabetes. Visit PreventDiabetesHawaii.com to learn more about the DOH’s “PREVENT | Diabetes Hawaii” campaign and access Provider Resources such as:
  • ICD codes for prediabetes and diabetes screenings
  • A quick, easy online diabetes risk test for patients
  • Printable handouts and other online resources for patients
  • Free prevent diabetes clinic posters
  • Ways to engage your health care team
We’ve also recently contracted with the YMCA to offer their diabetes education program to qualifying UHA members.

Find out more about YMCA’s Diabetes Prevention program on their website, or at https://uhahealth.com/page/diabetes.

Mod 25 Reminder

UHA requests that documentation be submitted with all claims billed with modifier 25 with an E&M service billed during the same encounter as the procedure.  The submission of documentation with the claim, like progress notes or a history and physical, will help UHA determine that modifier 25 has been used appropriately.  Please visit UHA’s medical payment policy on Office Visits and Consultations for more information.
View the full UHA Newsletter "Better Health, Better Life" - Spring 2017