Meet Your Liaisons

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Nalani Ponce

Outreach Liaison

"Maintaining a positive relationship with our providers is my goal. I appreciate their continued support in providing quality care to our members."


Request a visit today!

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Christopher Reyes

Physician Liaison

"Supporting all physicians in the UHA network and the community at large."


Coronavirus (COVID-19) Information for Providers

Updated June 1, 2020


For general information on Coronavirus/COVID-19, click here.

Payment policies for medical services related to COVID-19

Telehealth Services Payment Policy

View the full details of our expanded telehealth services in support of CDC guidelines and federal mandates effective March 01, 2020.

View Policy

COVID-19 Serology (IgG or IgM) Testing Payment Policy

COVID-19 Serology (IgG or IgM) testing is a covered benefit under the federal COVID-19 state of emergency and when the test meets the state statutory definition of “medical necessity.” UHA must follow both federal and state guidelines and mandates.

View Policy

COVID-19 testing and diagnosis codes

UHA Health Insurance is covering 100% of the cost for all services related to the diagnosis of COVID-19.  For inpatient hospitalizations, UHA is paying 100% of the UHA eligible charge.  Member co-pays, coinsurance and deductibles will be waived during the COVID-19 state of emergency. Claims submitted with the following ICD-10 diagnosis codes defined by the Center for Disease Control (CDC) will be identified as the diagnosis or treatment of COVID-19.

  • U07.1
  • Z03.818
  • Z20.828
  • Z11.59

Reference: CDC Coding Guidelines

Claims without the CDC identified COVID-19 related diagnosis codes will be processed to include co-pays, coinsurance and deductibles defined in the member’s plan medical benefits guide. We appreciate you working with us to ensure those individuals and families affected by COVID-19 are not negatively financially impacted.


Telehealth coverage during the COVID-19 state of emergency

To allow Providers to better serve our members as changes quickly occur during the COVID-19 state of emergency: 

  • All copays, coinsurance and deductibles are waived for all telemedicine encounters with a UHA participating provider* for the duration of the COVID-19 state of emergency regardless of the primary purpose of the visit.
  • UHA Health Insurance is covering standard telephone calls when pertinent and sufficient information to support medically necessary decision making is exchanged.
  • Providers are no longer limited to web-based, video conferencing or asynchronous information exchange tools.

*Telehealth visits with a non-participating provider are also covered at 100% when COVID-19 related.  Otherwise, standard benefits will apply when telehealth service is rendered by a non-participating provider

These changes in policy mirrors industry standards set by Medicare, America's Health Insurance Plans recommendations and other national carriers.

We believe this will allow you to continue to provide care to your patients without requiring face-to-face visits for patients who are experiencing COVID-19 related symptoms or who are in need of medical advice but unable to seek face to face care because of the COVID-19 crisis.

If you have any questions, please call our Health Care Services Specialists at 808.532.4006 or toll free 800.458.4600, ext. 300.


Telehealth FAQs

Policy/Guidelines

A1. For full details, please see our Telehealth Services payment policy.

Telehealth services are covered (subject to Limitations and Administrative Guidelines) when all criteria are met as stated in our policy. The policy will cover criteria such as, but not limited to:

  • Methods of how the service is delivered (video/audio, telephone calls, platform, etc.)
  • Geographic restrictions on a patient’s or health care provider’s location

For assistance with questions regarding our policy, please email or call Customer Services at:

Customer Services
Phone: (808) 532-4000
Toll free: (800) 458-4600
Email: Customer Services Contact Form

A. The services we cover for behavioral health are listed in our medical payment policy. As long as the criteria/guidelines for telehealth services are met, we will cover those specific behavioral health services.

A. Yes, as long as all telehealth criteria are met.

The Health and Human Services Office for Civil Rights (OCR) will exercise its enforcement discretion and will not pursue otherwise applicable penalties for breaches that result from the good faith provision of telehealth services during the COVID-19 nationwide public health emergency. Visit the HHS.gov web page for more information.

Payment, Coverage, Reimbursement, Coding

A. A detailed list of accepted codes and the description of services for each are available in our Telehealth Services policy. If you do not see a service or code listed in our policy, please contact Customer Services to verify if coverage is available.

Customer Services
Phone: (808) 532-4000
Toll free: (800) 458-4600
Email: Customer Services Contact Form

A. Reimbursement is defined in your contract terms. If you have any questions regarding reimbursement, please email Contracting Services.

A. Please continue to submit your claims to UHA. We would prefer electronic billing. If you wish to sign up to submit your claims electronically please visit our page on Provider Claims Submission. If you are interested in receiving payments from UHA electronically, please sign up for EFT payments by completing the EFT Request Form and sending it to our Contracting Services department.

A. The process for COVID-19 related claims is new to everyone, it's possible there may be mistakes made. Rest assured, we will work quickly to resolve any issues. We appreciate your patience as we work through this.

If you have any questions or need assistance, please contact Customer Services.

Customer Services
Phone: (808) 532-4000
Toll free: (800) 458-4600
Email: Customer Services Contact Form


COVID-19 Testing and Diagnosis FAQs

A. Claims submitted with the following ICD-10 diagnosis codes defined by the Center for Disease Control (CDC) will be identified as the diagnosis or treatment of COVID-19.

Claims without the CDC identified COVID-19 related diagnosis codes will be processed to include co-pays, coinsurance and deductibles defined in the member’s plan medical benefits guide. We appreciate you working with us to ensure those individuals and families affected by COVID-19 are not negatively financially impacted.

  • U07.1: Confirmed diagnosis (see CDC Coding Guidelines for all scenarios)
  • Z03.818: Encounter for observation for suspected exposure to other biological agents ruled out.
  • Z20.828: Contact with and (suspected) exposure to other viral communicable diseases.
  • Z11.59: Encounter for screening for other viral diseases

A. UHA will cover appropriate, medically necessary diagnostic testing for COVID-19, per Centers for Disease Control and Prevention (CDC) guidelines and Hawaii Department of Health’s (HDOH) mandated coverage. Current CDC guidelines can be found here.

A. Regardless of the primary purpose of the visit, 100% of eligible charges with no copay or deductibles will be covered on any telehealth service rendered with a participating provider in UHA’s network during the COVID-19 emergency period.

All telehealth visits are covered at 100% of eligible charge when related to COVID-19 diagnosis, effective 3/01/20. This includes visits to a doctor’s office, urgent care facilities, emergency room, telehealth visits, virtual check-in, and e-visits. This means that UHA members diagnosed with COVID-19 will have all associated copayments, coinsurance, and deductibles covered whether or not the services received are from a UHA participating or non-participating provider. However, standard benefits apply when members have a telehealth visit with a non-participating provider.*

* Telehealth covered at 100% of eligible charges with no copay or deductibles when rendered by a participating provider in UHA’s network. Benefits valid only for the duration of the COVID-19 emergency period. The conditions for the coverage of telehealth copays can be found in UHA’s current Telehealth Services Payment Policy. Or call UHA to find out more.

A. COVID-19 serology (IgG or IgM) testing is commonly known as “antibody testing.” Such testing is a covered benefit under the federal COVID-19 state of emergency only when the test meets the statutory definition of “medical necessity.”

Currently, CDC’s serologic test is designed and validated for broad-based surveillance and research that will provide information needed to guide the response to the pandemic and protect the public’s health.

The test is not currently designed to test individuals wanting to know if they have been previously infected with COVID-19, and both the CDC and Hawai‘i Department of Health (DOH) do not recommend COVID-19 individual antibody testing at the present time.

Furthermore, the American Medical Association has taken a position on not using serology testing for the sole determination of immunity to COVID-19 secondary to testing limitations along with potential false positive and/or negative results. Read their guidance here.

While we completely support clinical advancements that improve diagnosis, treatment, and prevention of COVID-19, serologic testing is complicated. The antibody testing is not currently recognized by the CDC as a valid diagnostic test for COVID-19 or a reliable test to demonstrate immunity, and serology testing is not known to be effective in improving health outcomes.

Accordingly, UHA does not endorse and will not cover tests without FDA standing and insists that the ordering provider be qualified to interpret the results in the context of the clinical situation and the public health milieu.

This is a rapidly changing situation that we will continue to monitor using the latest guidance from the CDC and DOH to determine which tests are medically necessary. As guidelines and recommendations evolve, we’ll continue to re-evaluate our policies.