Mark H. Yamakawa
HDS President & CEO
Aloha Participating Providers,
The Coronavirus (COVID-19) pandemic has affected all businesses throughout Hawaii, and we understand it continues to be a burden on your operations. As our communities start to recover and you open your practices to more people in need of dental care, Hawaii Dental Service (HDS) is here to help you with your operational needs.
We are offering the HDS COVID-19 Interim Supplemental Program (the “Program”) – a new, temporary financial support program that DOES NOT have to be repaid to HDS – to help practices alleviate the costs associated with resuming dental operations during the COVID-19 pandemic.
HOW THE PROGRAM WORKS:
- A $10 supplemental payment will be provided, per each eligible commercial and Medicaid patient visit, to the payee of HDS participating dentist(s) in Hawaii, Guam, and Saipan.
- Participating dentists do not have to opt-in to the Program and will automatically receive monthly supplemental payments for eligible patient visits. To opt-out of the Program, contact HDS Professional Relations at [email protected]
- The Program’s eligible time period is retroactive from May 1, 2020 through December 31, 2020.
- One total payment, for all eligible patient visits during the month, will be made for three (3) months and added to a single weekly claim payment that month. If there are no claim payments due the week the supplemental payment is distributed, it will be included in the next week’s claim payment.
- The supplemental payment amount(s) will be noted on the participating dentist’s remittance advice under the “non-claim adjustment” category.
- These payments do not have to be repaid to HDS and will be included on the 2020 IRS Form 1099. Please consult with your accountant for any tax-related questions or concerns.
WHAT PATIENT VISITS ARE ELIGIBLE?
- Patient visits are counted once per patient, per date of service, per provider, and per service location, during the Program time period, May 1, 2020 through December 31, 2020.
- Pre-authorizations, duplicate claims for patient visits, non-par visits, and teledentistry patient encounters are not eligible. Please also note that per HDS Policy, you may not charge PPE costs to the patient.
- Orthodontists that want to participate will submit a patient visit claim using administrative code D8999, with the narrative “COVID-19” and a $0.00 charge amount.
- Claims for patient visits must be received by January 31, 2021 and be in “paid” status by February 28, 2021 to be eligible.
Frequently Asked Questions (FAQ)
PROGRAM BASICS AND PARTICIPATION
- What is this program about?
This is a temporary financial support program for HDS participating dentists to help with costs associated with resuming dental operations in this unprecedented situation due to the COVID-19 pandemic. HDS will make a bulk payment into your HDS claim payment check at the end of each month during the program period based on eligible patient visits with service dates between May 1, 2020 through December 31, 2020.
- Do I have to repay this supplemental support payment?
No, this is a gratis program for HDS participating dentists located in Hawaii, Guam, and Saipan.
- Do I have to apply or inform HDS if I want to participate?
No, if you are an HDS participating dentist and treat patients during the Program time period you are automatically eligible.
- Can I opt-out of this program?
Yes, please call HDS Professional Relations at (808) 529-9222 or toll free 1-844-379-4324 and you will be exempted from the Program and will not receive any additional financial support payments.
- How is this different from the Advance Payment Program HDS offered in March?
The HDS Advance Payment Program was a prepayment of future claim payments to be repaid later. This program does not have to be repaid.
PAYMENTS
- How does this payment appear on my weekly claim payment?
This payment will only be provided once a month. It will be listed on the non-claim adjustment category under one of the providers in your practice, however it is based on eligible patient visits for all providers.
- Do I credit these payments to my patients?
No. It is a bulk payment to support your business.
- Are payments separated by provider?
No. It is a bulk payment to the payee on file. Calculations will be based on eligible patient visits from all providers in your practice that belong to the payee on file.
- Can I get the payment outside of my HDS weekly claim payment?
No, it will be included once a month, added to your weekly claim payment.
- I also participated in the HDS Advance Payment Program (APP), and HDS will be deducting the agreed upon amount from each check starting in July. Will I have both a deduction from the APP repayment and an addition for the COVID-19 Interim Supplemental Program on the same check?
Yes, it is very likely that one check per month may have two non-claim adjustments. One will be a deduction for the agreed upon APP repayment amount, and another will be a payment for the additional COVID-19 Interim Supplemental Program. These will be on two separate lines so that it will be clear what each is for.
CLAIM SUBMISSION
- Do I have to submit claims within a certain time period?
Yes. Payments will be based on eligible patient visits from May 1, 2020 through December 31, 2020. To be eligible for this payment, claims for patient visits must be received by January 31, 2021. However, as a best practice HDS recommends you submit claims on the date of service if possible and no later than 7 calendar days after.
- Do I have to write a special comment or use a special CDT code on the claim for it to qualify?
No. Submit the claim as you normally would. HDS will include the claim based on service dates. The procedures completed at the reported patient visit should not be split into multiple claims. To be eligible, the procedures should be submitted on a single claim per date of service.
- How do I get support for orthodontic maintenance procedures since a claim is not submitted with each visit?
Submit a claim using CDT Code D8999, with a $0.00 charge amount and include the narrative “COVID-19” for each orthodontic maintenance procedure visit. These visits will be included in the bulk payment.
- Can I get a report of the claim volume HDS used to calculate my payment?
No. HDS is trying to administer this program as quickly and efficiently as possible and individual reports will not be provided.
- Do I have to pay taxes on these payments?
These payments will be included on your 2020 IRS Form 1099. Please check with your accountant regarding tax questions.
Additional Questions? Please contact HDS Professional Relations at [email protected], via phone at (808) 529-9222 or toll free at 1-844-379-4324.