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Health Plan Manual - Encounter - Department of Human Services - med-quest

Health Plan Manual - Encounter - Department of Human Services - med-quest 2025

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The document is the 'Hawaii Prepaid Medical Management Information System Health Plan Manual - Encounters' (Version 2.4, July 2016), which outlines the policies and procedures for health plans in Hawaii regarding encounter data submission and processing. It details the requirements for electronic submission of encounter data, definitions of encounters, reporting guidelines, penalties for late or inaccurate submissions, and technical specifications for file formats. The manual serves as a comprehensive guide for medical and behavioral health plans contracted with the Hawaii Department of Human Services to ensure compliance with encounter reporting standards.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is Medicaid in Hawaii called?

What is Med-QUEST? Med-QUEST (Quality, Universal Access, Efficiency, Sustainability, Transformation) is a division of the Department of Human Services that provides healthcare benefits to Hawaii residents who are eligible for Medicaid.

What if my income is too high for medical?

If your monthly income is higher than the limits to qualify for SSI or the AD FPL program (see above), you may still be eligible for Medi-Cal with a share of cost (SOC). An SOC functions like a deductible. You must pay this amount in any month you incur medical costs.

What is the income limit for Med-QUEST in Hawaii?

You may be eligible for QUEST (Medicaid) if: Youre 19 or older with a total household income at or below 138% of the federal poverty level (for example, $23,888 for a single person or $49,514 for a family of 4 in 2024)

What is the difference between Med-QUEST and Medicaid?

Medicaid, or Med-QUEST in HI, is a health insurance program for low-income individuals of all ages. While this program provides coverage for various groups of Hawaii residents, our focus is on long-term care Medicaid eligibility for elders, aged 65 and over.

What is the income limit for section 8 in Hawaii?

Factors of Eligibility FY 2024 Income Limits Very Low Income $48,750 $75,200 (APPLICATIONS-50% of Median) Low Income-80% $77,950 $120,300 Median Family Income (MFI) $120,1004 more rows

What is the max income for medical card?

Qualifying Financial threshold If John has weekly net earnings of 395.62 or below, he will qualify for a medical card.

What are the income requirements for Med-QUEST Hawaii?

Income Limits The monthly income limit is set at 100% of the Federal Poverty Level (FPL). It should be noted that Hawaii has higher Federal Poverty Level limits than the other states, with the exception of Alaska. In dollar terms, for 2024, an applicant cannot have more than $1,442.50 per month in income.

How to cancel Med-QUEST Hawaii?

If you no longer need QUEST (Medicaid) coverage, call Med-QUEST at 1-800-316-8005, (TTY/TDD 711) to let them know.

Health Plan Manual - Encounter - Department of Human Services - med-quest 2025

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