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Provider Handbook Updates

Provider Handbook Updates

in Important Notices by UHA Health Insurance

Information and sample forms provided in the handbook are subject to change at any time. This page contains the most current updates that may not be included in your version of the Provider Handbook.

QUESTIONS? Call UHA Customer Services at 532-4000, or 1-800-458-4600 from the neighbor islands

January 1, 2022

Subject: UHA Professional Credentialing Requirements
Handbook Page #: 2
Original: N/A
Amendment:

UHA Professional Credentialing Requirements

Listed in the table below are general professional credentialing requirements for providers UHA reviews and verifies when selecting providers to join UHA’s healthcare network.

View table of requirements (PDF)

Subject: Table of Contents
Handbook Page #: Table of Contents pages

Original:
HOW TO CONTACT EXPRESS SCRIPTS ……………………. 2
DEFINITIONS………………………..……….……………….2

Amendment:
HOW TO CONTACT EXPRESS SCRIPTS …………………………………..2
UHA PROFESSIONAL CREDENTIALING REQUIREMENTS……………2
DEFINITIONS ……………………………………………………………..11

November 17, 2021

Subject: Submitting drug PAs online through eviCore Healthcare
Handbook Page #: 3
Amendment:
Online prior authorizations for drugs listed in UHA’s MBM formulary are now processed through eviCore Healthcare effective November 17, 2021. Submit online via the eviCore.com portal at: https://ww.evicore.com/provider#login.

Subject: Requesting Reconsideration of a Claim for Payment
Handbook Page #: 29
Amendment:
When the review has been completed, we will either reprocess the claim, in which case you will receive a new Remittance Advice, or we will inform you why we believe our original determination was correct. If the matter is not resolved to your satisfaction, you must appeal the decision as described in the “Appeals Process” section.

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