'Ohana Health Plan aims to ensure that claims are handled as efficiently as possible. Providers can help facilitate timely claim payment by having an understanding of our processes and requirements. The following materials may change periodically so please check for updates.
From time to time, we review our reimbursement policies to maintain close alignment with industry standards and coding updates released by health care industry sources like the Centers for Medicare and Medicaid Services (CMS), and nationally recognized health and medical societies.
Institutional Claims/Encounter Guides
- 837 Institutional Encounter 5010v Guide - English (PDF)
- 837 Institutional FFS Claims 5010v Guide - English (PDF)
Professional Claims/Encounter Guides
- 837 Professional Encounter 5010v Guide - English (PDF)
- 837 Professional FFS Claims 5010v Guide - English (PDF)