Frequently Asked Questions for Clients
What is the SHOTT program?
The State of Hawaii Organ and Tissue Transplant, or SHOTT, program coordinates medical services for Hawaii Medicaid patients who require an organ or tissue transplant. Koan Risk Solutions has been contracted by the Hawaii Medicaid (Med-QUEST) to assist clients and providers and administer the SHOTT program.
What expenses does the SHOTT program cover?
The SHOTT program covers the cost of your approved medical and associated expenses while you are with the program.
Does the SHOTT program pay for my travel expenses if I travel to the mainland for my transplant?
Yes, the SHOTT program will cover your travel related expenses. A Koan case manager will set up your flight arrangements, hotel accommodations and ground transportation for any mainland or interisland travel. You will also receive a $30 per day meal reimbursement when you must travel for more than a day for medical appointments and are not admitted to a hospital. (Children 10 and under receive a $15 per day meal reimbursement)
Does the SHOTT program cover costs for my caregiver’s travel?
Yes, the SHOTT program will cover travel expenses for your caregiver. The individual will also receive a $30 per day meal allowance.
Does the SHOTT program pay for dental work?
Due to the expansion of the Medicaid dental benefit through Hawaii Dental Service (HDS) starting January 1, 2023, SHOTT patient’s primary dental coverage is through their Medicaid benefit through HDS. SHOTT patients should inform their case manager if HDS has denied any of their dental claims.
How long will I be with the SHOTT program?
You will remain with the SHOTT program for one year after your transplant. At that time, you will be transitioned back to the Medicaid QUEST plan of your choice.
Does the SHOTT program cover non-transplant related services?
Yes, the SHOTT program covers all medically necessary services while you are with the program.
Will the SHOTT program pay my caregiver for providing care and chore services?
No, the SHOTT program does not pay for services provided by your caregiver.
Will the SHOTT program cover my medications?
Yes, your medications will be covered by Medicaid while you are with the SHOTT program. Hawaii Medicaid (Med-QUEST) uses a company named Conduent to provide these benefits. Your Case Manager can explain this to you in greater detail.
Whom should I contact for additional information regarding my SHOTT benefits?
Each SHOTT patient is assigned a Case Manager who thoroughly explains the SHOTT Program benefits and guides the patient through the transplant process. Your case manager is available to you on a 24/7 basis.
Any additional questions? Please contact your Case Manager or the Koan office at 808-469-4500 or by e-mail at firstname.lastname@example.org
Frequently Asked Questions for Providers
Am I credentialed with Koan Risk Solutions (Koan)?
If you are credentialed with Hawaii Medicaid Fee for Service, you are credentialed with Koan. If you’re unsure whether you’re credentialed with Hawaii Medicaid Fee for Service call us – Koan – at 808-469-4500 and we’ll check for you.
How can my office check on the status of a particular claim?
Contact Koan’s claims department at 808-469-4500 and provide us with the patient’s name, the date of service and the amount of the claim.
To what address should my office send claims for processing?
Mail all claims to 1580 Makaloa St. #550 Honolulu, HI 96814.
Can my office submit claims to Koan electronically or by fax?
Koan accepts claims electronically through Smart Data Solutions (SDS). Koan’s payor ID is 65871. Koan does not accept claims by fax. Hard copy claims can be mailed to Koan address at 1580 Makaloa St. #550 Honolulu, HI 96814. Hard copy claims need to have a live ink signature, or they will be denied.
How much time does my office have to submit the claim?
You have one year from the date of service. Any claim submitted more than one year from the date of service requires an approved waiver by Hawaii Medicaid. To obtain a waiver, send a copy of the claim along with a letter addressed to the MedQUEST Health Care Financing Program Specialist, 1001 Kamokila Blvd. #301A, Kapolei, HI 96707, requesting approval of late submission and explaining why the claim was not processed within the one year filing period. Once approved, mail a copy of the waiver along with the original signed claim to Koan Risk Solutions.
How do I find out if a procedure requires prior authorization?
Contact Koan at 808-469-4500 and we will advise you.
How will my office find out if a claim is denied?
If a claim is denied, Koan will send a letter to inform and explain the reason for denying the claim.