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UHA Health Insurance Summer 2017 Newsletter
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Message from the CEO

Diabetes Management, Prevention and Taking Control of Your Health

Diabetes is a growing epidemic with a heavy economic burden. It has cost the state an estimated $1.5 billion each year. Diabetes is a leading cause of other chronic diseases like kidney disease. About 154 thousand people in Hawaii are afflicted by diabetes, and another 442 thousand are affected by prediabetes but only one-third of them know it.  Without intervention, 15% to 30% of them will develop type 2 diabetes within 5 years.These are huge numbers that will contribute to increased overall health care costs over time if nothing is done. Other factors which increase the cost of health care, like the development of new drugs and medical devices, are out of our control. The good news is that diabetes is largely preventable and manageable and we can control the costs and outcomes associated with it through prevention and lifestyle changes. In fact, about 9 in 10 cases of type 2 diabetes can be avoided by addressing factors such as being at a healthy weight, increased physical activity, eating nutritiously and not smoking. 2
 
 At UHA, we are committed to keeping our members healthy through prevention and wellness. We are proud to offer the YMCA’s Diabetes Prevention Program free of charge to qualifying UHA Members who are at risk for prediabetes. Those with diabetes could also be at risk of contracting Chronic Kidney Disease. We encourage you to learn more about managing Chronic Kidney Disease through the free courses offered by Aloha Kidney.
 
Each of us has the most control over the choices we make on a daily basis, which nudge us toward or away from chronic disease.  We encourage you to check out these programs and take control of your health and wellness today.

Aloha,
Howard Lee
UHA President & CEO

  1. Centers for Disease Control and Prevention. 9/22/2016
  2. Hu FB, MasonJE, Stampfer MJ, Coldotz G, Liu S, et al. 2001. “Diet , lifestyle and the risk of type 2 diabetes mellitus in women.”  N Engl J Med, 245 (II): 790-7.
Provider Voice
 

Prediabetes 

Article based on the July 10, 2017 episode of "The Body Show" featuring an interview with Erin Farmer and Valerie Lawson of the YMCA of Honolulu 

Prediabetes is a silent epidemic in Hawai'i—however, it's a condition that can be reversed with clear goals, and simple steps. It’s easy to find out if you have pre-diabetes—a simple blood test will reveal what your blood sugar levels are. And the good news is, pre-diabetes is treatable by adopting lifestyle changes such as eating healthier foods and getting more exercise.

Read more

Automated Claims Review for Medical Drugs


Effective August 1, 2017, UHA will be begin using an automated claims review process for infusion and injectable drugs billed on CMS-1500 medical claims. 
This process will ensure that providers are consistently and appropriately reimbursed and will validate that the units billed match the quantity of drug(s) administered to the patient and approved through the prior authorization process. 
Below are a few reminders about how to bill for infusion and injectable drugs so there is no disruption to your claims payments:
  • Include both a “From” and “To” date on each claim to ensure that the units billed match the quantity allowed for the date(s) of service.
  • Bill for waste individually on a separate claim line using modifier JW.
  • Indicate the appropriate HCPCS code corresponding to the NDC indicated on the claim. 
    • Avoid billing with J3490 if there is a more specific HCPCS code available.
Additional Questions? You can contact our Customer Services Department at:

NEW! Online Participating Provider Service Location Form


Do you have an additional office location at which you provide medical care to UHA members? If so, participating providers now have the ability to add a service location online.  The Online Participating Provider Service Location Form  is available on our Forms and Documents page, under the “Provider Forms” tab.
View form

YMCA's Diabetes Prevention Program



We are proud to announce that UHA is the first insurer in the state to contract with the YMCA and fully cover the YMCA’s Diabetes Prevention Program (Y-DPP) with no cost to your patients. Research by the National Institutes of Health has shown that programs like the Y-DPP can reduce the number of new cases of Type 2 Diabetes by 58% and by 71% in adults over age 60. This successful program is available to individuals who meet the following criteria:
  1. At least 18 years old
  2. Overweight – defined as having a BMI ≥ 25 (≥ 22 for Asian individuals)
  3. Blood test from the past year with one of the following results:
    1. Fasting plasma glucose between 100-125 mg/dL
    2. 2-hour plasma glucose between 140-199 mg/dL
    3. A1c between 5.7% and 6.4%
  4. Previously diagnosed with gestational diabetes
  5. If a blood test is not available, a qualifying diabetes risk score from the CDC Test.
Patients are more likely to participate in lifestyle changing programs if physicians recommend them. We strongly encourage you to refer qualifying UHA members to the Y-DPP.

Please visit the YMCA of Honolulu’s website for more information about their Diabetes Prevention Program or check out this podcast featuring Dr. Kathleen Kozak, host of "The Body Show," and guests Erin Farmer and Valerie Lawson of the YMCA, discusssing the YMCA Diabetes Prevention Program.
Get more info about YMCA's DPP on uhahealth.com

Aloha Kidney Classes

Dr. Ramona Wong, creator of Aloha Kidney, has recently completed a short video introducing her educational program on kidney disease and philosophy behind healthy living. UHA supports Dr. Wong’s Aloha Kidney classes, which promote chronic kidney disease (CKD) awareness and management. For more information, please visit the Aloha Kidney website.
We encourage you to refer your patients to this video, which will be posted on the UHA website, and to Dr. Wong’s classes.

Do you have patients with asthma?


Patients who are UHA members may be referred to UHA’s Certified Asthma Educator, Constance Saunders RN, MN, CCM, AE-C. Please visit the Asthma Management page on our website for more information.

Members interested in enrolling should contact Health Care Services at 808-532-4006.
Download patient brochure

UHA Benefit Updates

  • Effective 6/15/17, Radiation Therapy – HCPCS code G6017 is now covered with approved prior authorization.  See code description below:
 
HCPCS Description
G6017 Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (e.g., 3D positional tracking, gating, 3D surface tracking), each fraction of treatment 
 
  • Effective 4/15/17, CPT codes 95921 to 95924 are non-covered services.  See code descriptions below:
 
CPT Description
95921 Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded R-R interval, Valsalva ratio, and 30:15 ratio
95922 Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and R-R interval changes during Valsalva maneuver and at least 5 minutes of passive tilt
95923 Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (QSART), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential
95924 Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt
#UHATurns20


 

Doreen, Nurse Administrator
Doreen, Nurse Administrator
"My motto is: ‘Work hard and play hard.’ I love my work, and when I am there I am totally committed. We go the extra mile every day to help our members in the best way we possibly can."
Royce, Contracts Specialist
Royce, Contracts Specialist
“We tell our members [the same things we encourage each other with]: 'We are here to make sure you are the best and healthiest you that you can be — so that you can do what you want to do for longer.'”
Check out their stories here!
Member Voice
 


YMCA Diabetes Prevention Program

UHA now offers the YMCA's Diabetes Prevention Program free of charge to qualifying UHA Members! This program gives you the skills you need and the support you deserve to make lasting healthy lifestyle changes. If you’re at risk for type 2 diabetes, you can make small, measurable, changes that can reduce your risk and help you live a happier, healthier life.

Find out if this program is for you.

Visit your doctor from home or work

UHA members can now see a doctor online from the comfort of their home or work. Search for a telemedicine doctor today through our "Find a Provider" search tool.

Employer Voice
 


Baseline Survey on State of Worksite Wellness in Hawaii

In early February of this year, the HH@WA partnered with research company Market Trends Pacific to survey local companies about workplace wellness. While data from wellness surveys exists on a national level, this is the first significant research survey of local organizations on wellness programs and their impact on companies’ financial performance.

Survey says...
Register today for the 2nd Annual Hawaii Wellness Leaders Conference!
What exactly is a "growth mindset"?
Watch this short video featuring HH@WA's 2017 keynote speaker, Carol Dweck
Upcoming Events

Every Saturday

8:00 AM @ Central O‘ahu Regional Park
•  Walk with a Doc

 

Saturday, August 12

7:00 AM @ Queen Kapiolani Park
•  American Heart Walk
 

Tuesday, August 15

8:00 AM @ Waikiki Health Center
•  Waikiki Health Wellness Fair
 
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