Provider

Thank you for your interest in our plan. 'Ohana Health Plan, a health plan offered by WellCare Health Insurance of Arizona, Inc., understands that maintaining a healthy community starts with providing care to those who need it most. As the largest Medicaid- and Medicare-only contractor in the nation, the WellCare group of companies offers affordable health care plans to individuals eligible for government-sponsored programs.

For more information or to learn how to become an 'Ohana provider, send an e-mail to providers@ohanahealthplan.com. 

Latest News

5010 Implementation
The Administrative Simplification Provision of the Health Insurance Portability and Accountability Act (HIPAA) requires standards for electronic transactions, such as claims (including pharmacy), remittance, eligibility and claims status. The current versions of these standards, X12 Version 4010/4010A1 and NCPDP Version 5.1 will be replaced with Version 5010 and Version D.0, respectively. The federally mandated compliance date is January 1st, 2012, but in alignment with CMS’ grace period on enforcement action, WellCare will allow both 4010 and 5010 transactions to be submitted until June 30th, 2012. Click here for more information.

 

Important Changes in Electronic Data Interchange (EDI) Process - effective July 24, 2011
'Ohana accepts electronic claims only through RelayHealth, a division of McKesson.  If your vendor (i.e., practice management system, billing service or clearinghouse) is not connected to RelayHealth, we strongly encourage you to contact them directly and request that they establish this FREE connection. Upon confirmation from your vendor of continued electronic claims submission to 'Ohana via RelayHealth, no further action is necessary.   
If you have questions regarding submission of EDI transactions directly through RelayHealth, please see the provider notice and FAQs for more information, or refer to your Quick Reference Guides for contact information for providers and vendors.

Successful Provider Partnerships Are a Priority

'Ohana has about 140 local employees staffed across six Hawaiian islands. More than half of our local employees are nurses, social workers and physicians, as well as a dedicated Provider Relations team. 'Ohana providers also benefit from partnerships with more than 3,800 employees nationwide focused on helping members receive the best health care available.

'Ohana's team of local Service Coordinators is trained to collaborate with physicians in providing the highest level of care to patients. In addition, providers and members can expect to benefit from our J.D. Power Award-winning customer service when contacting us by telephone.

Easy Access to Important Information
Click on the Resources tab above to access the wealth of information this website has available for our physician and provider partners or use the other tabs to access useful resources like claims, authorizations and eligibility information from the secure provider-only portion of this site.

Not Registered?
As part of 'Ohana's network of providers, you can take advantage of a variety of services available on this site to manage your 'Ohana online account.  Your user name and password are required to access our secure provider only portal. 

Register Today! Sign Up Here

If you have a question and cannot find the answer, don’t hesitate to submit that request to us via our online form.