Resources
Click the links below to access such resources as online claims transaction guides, the provider manual and brochures, which will assist you in working with 'Ohana Health Plan.
- CMS-Mandated Fraud, Waste and Abuse Training
The Centers for Medicare & Medicaid Services (CMS) has mandated that all delegated and contracted providers who render benefits or services for Medicare Part C and Part D programs must meet fraud, waste and abuse (FWA) training requirements by December 31, 2009. Click here for more information on how to fulfill this requirement.
- Become an 'Ohana Provider
- 'Ohana Brochures
All About 'Ohana
PaySpan Health: Health Care Payment and Remittance Advice
Provider Responsibilities
- Claims Updates
This page provides updates and information on 'Ohana Health Plan's claims processes, ensuring that provider claims are handled efficiently.
- Clinical Coverage Guidelines
Clinical Coverage Guidelines (CCG) are evidence-based documents detailing the medical necessity of given procedures or technologies. The guidelines set consistent criteria for the coverage of a procedure or technology, leading to greater consistency and efficiency in clinical decision making.
- Medicaid Provider Manual
Medicaid Quick Reference Guide
Medicaid Forms
Medicaid Education Materials
- Medicare Provider Manual
Medicare Quick Reference Guide
Medicare Forms
Medicare Education Materials
- Provider Job Aids
Job aids are step-by-step work instructions on how to perform daily tasks with 'Ohana Health Plan.
- Provider Newsletters
'Ohana Health Plan produces newsletters to update providers on information related to pharmaceuticals, cost and quality of care or share tips on how to perform better and more efficient business with the plan. The newsletters are also used to highlight recent successes, such as accreditations and quality scores.
2010 Issue II
Winter 2009
Fall 2009
Summer 2009
Spring 2009
- Long-Term Care Facilities Updates
Please check this site regularly for important information for Long-Term Care Facilities.
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