Benefit Services of Hawaii. – sol(u)tions

This is to clarify how bitewings are processed when taken within 12 months of a FMX.

* If bitewings have been taken prior to a FMX, no limitation applies and both procedures will be paid.
* If bitewings are submitted within 12 months after a FMX has been paid, then the bitewings are denied due to the 1 in 12 month limitation for bitewings. The member will be responsible for the cost of the bitewings.

The CDT Dental Code book defines code D2951, pin retention as a per tooth service, regardless of the number of pins placed. Our dental policy allows code D2951 to be performed two times per tooth as a lifetime maximum. To be eligible for payment, services must occur 12 months apart.

Oral Health for Total Health Provider Brochure (pdf)

HMSA Enhanced Dental Benefits.pdf (pdf)

HMSA Dental Plus Plan for 2013 (pdf)
Notice to Providers (pdf)

Important Information-New Claim Administrator Eff 9-1-12.pdf (pdf)

As part of our new dental administrator transition, beginning in September there will be a change in the payment approach for General Excise Tax for the Fed87 program. These payments will now be made on a monthly schedule in one convenient check to the provider of service by TIN. As an added service, the payment will include a statement showing the amount of tax paid for each patient, based on the allowable amount for covered services by date of service. In the future, you’ll also be able to view these statements online through the new provider portal.

If you currently calculate and submit tax for payment, you’ll see a message on the Explanation of Benefits advising you of the new payment process. If you currently do not submit tax for payment, it will automatically be calculated and sent to you monthly.

Hawaii State General Excise Tax FAQ (pdf)
General Excise Tax Remittance with Check (pdf)
Detailed General Excise Tax Provider Report (pdf)

All Hawaii dental providers will continue to contact the HMSA Dental Customer Service Representatives on Oahu at 948-6440 or toll free at 1-800-792-4672. Please disregard the Dental Customer Service contact number that was included in the recent HMSA Dental Participating Provider Re-Contracting package and CD.