Resources For Providers

We want to make sure that you have additional resources to take care of our members. Below is a list of resources and links that you may find helpful. 

AlohaCare Provider Training Webinars 2024

AlohaCare Provider Training Webinars 2023

AlohaCare Provider Training Webinars 2021 and 2022

We encourage you and your staff to review our training materials and complete the training acknowledgement form (click here), and fax it to Provider Relations unit at 808-973-0811. If you would like to request in-person or remote training, please call Provider Relations at 808-973-1650 or toll-free at 1-800-434-1002.

Mahalo for your participation and continued support to our members!

AlohaCare Advantage Plus is a dual-eligible Special Needs Plan (SNP). One advantage for members of SNP plans is the SNP Model of Care, which is an interdisciplinary care coordination program.

The following are links to resources related to the SNP Model of Care.
Click here for more information about AlohaCare's credentialing process.
 
Benefits of Submitting Claims Electronically via EDI:
 
  • Expedite claims processing and payment.
  • Decrease administrative, postage and supplies costs.
  • Provides rapid notification of claims receipt and status.

Click here for more information about how to submit claims electronically.

 
Gateway also known as Trizetto
Phone Number: 800-969-3666
 
Legacy also known as Hawaii X-Change & Administep
Phone Number: 888-751-3271 ext. 3127
Note: Office Ally submits claims via this clearing house vendor.
 
Change Health
Phone Number: 866-817-3813
 
Waystar also known as ClaimRemedi & eSolutions
Phone Number: 877-635-2920
 
NextGen
Phone Number: 1-800-426-3385
 
**Providers, Practices and Facilities that have delegated their claims submissions for AlohaCare to a Physician Billing or Practice Management Services Company may work with our clearing house partners to establish EDI claims submission capabilities for AlohaCare.
 

Information about Zelis ePayment Center

How do I register?

  • Visit https://alohacare.epayment.center/registration
  • Follow the instructions to obtain a registration code.
  • Your registration will be reviewed by a customer service representative and a link will be sent to your email once confirmed.
  • Follow the link to complete your registration and setup your account.
  • Log into the portal.
  • Enter your bank account information.
  • Select remittance data format options.
  • Review and accept ACH Agreement.
  • Click "Submit."

Note: Upon completion of the registration process, your bank account will undergo a pre-notification process to validate the account prior to commencing the EFT delivery. This process may take up to six business days to complete.

 

What do I need to register for the ePayment Center?

  • 9-digit Federal Tax Identification Number (TIN) or Employer Identification Number (EIN)
  • Practice's corporate name and principal information
  • Bank account routing transit number (RTN) or ABA Routing Number
  • Bank account number

 

Where can I find more information/assistance on the registration process?

Go to alohacare.epayment.center/registration for more information. You may call 855-774-4392 or email at help@epayment.center with your questions. 

 

CME Eligible Vaccine Hesitancy Training Now Available

In collaboration with Hawaii MQD and the Centene Institute for Advanced Health Education®, all MedQUEST Health Plans are pleased to offer providers with a new CME eligible training: “Vaccine Hesitancy: How to Identify and Approach the “Movable Middle”.

This course will provide education for primary care providers in addressing vaccine hesitancy in order to increase rates of COVID-19 and other vaccinations. Other practical topics discussed include COVID-19 misinformation (such as infertility/reproduction and myocarditis) and information on becoming a COVID-19 vaccine provider.

At the close of this activity, participants will be able to more comfortably discuss barriers to vaccine uptake and patient misconceptions and misinformation about vaccinations for COVID-19. Additionally, participants will learn multiple strategies to promote vaccinations for a variety of diseases and to implement motivational interviewing and other evidence-based communication tools to promote vaccinations. The program also addresses cultural considerations for special populations with whom you may work.

Registration: This course is accessible through www.centeneinstitute.com. Once you have registered as a new user, navigate to the Activity Catalog. In the Activity Catalog, search for the course title and register by clicking on ENROLL NOW.

An overview of the course, including information on continuing education credit available for physicians and nurses, can be found at: https://www.centeneinstitute.com/activities/618aded5ae0a950008002d34/overview.

For any questions on the course or enrollment process, please contact the Centene Institute for Advanced Health Education® at Centene_Institute@centene.com.

 

The National Plan and Provider Enumeration System (NPPES) serves as the national system designed to assign unique identifiers to health care providers and health plans who apply for the National Provider Identifier (NPI).

Please take the time to review your NPI data in NPPES as soon as possible to ensure that accurate provider data is displayed. As you may know, providers are legally required to keep their NPPES data current. Centers for Medicare & Medicaid Services (CMS) is also encouraging Medicare Advantage Organizations to use NPPES as a resource for our online provider directories. By using NPPES, we can decrease the frequency by which we contact you for updated directory information and provide more reliable information to Medicare beneficiaries.

If the NPPES database is kept up to date by providers, AlohaCare can rely on it as a primary data resource for our provider directories, instead of calling your office for this information. With updated information, we can download the NPPES database and compare the provider data to the information in our existing provider directory to verify its accuracy.

When reviewing your provider data in NPPES, please update any inaccurate information in modifiable fields including provider name, mailing address, telephone and fax numbers, and specialty, to name a few. You should also make sure to include all addresses where you practice and actively see patients and where a patient can call and make an appointment. Do not include addresses where you could see a patient, but do not actively practice. Please remove any practice locations that are no longer in use. Once you update your information, you will need to confirm it is accurate by certifying it in NPPES. Remember, NPPES has no bearing on billing Medicare Fee-For-Service.

If you have any questions pertaining to NPPES, you may reference NPPES help at https://nppes.cms.hhs.gov/webhelp/nppeshelp/NPPES%20FAQS.html#

For more information about NPI and how to obtain an NPI, please visit the NPPES website. Visit the NPPES website

Below is a list of resources that you may find helpful. By clicking on any of the links below, you will be leaving the AlohaCare website.

  1. Med-QUEST
  2. Center for Medicare and Medcaid Services (CMS)
  3. Noridian Medicare
  4. National Committee for Quality Assurance (NCQA)
  5. Urgent Care - Urgent care services can be accessed when a member is experiencing an illness or injury that requires urgent attention that cannot be delayed when a member’s Primary Care Provider (PCP) or health center is not accessible during normal business hours or when after hour care is needed. Click here for a list of participating Urgent Care Clinics and Community Health Centers with extended hours.