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/  Medicare Advantage Network

Medicare Advantage Network

Akamai Advantage Dual Care Dental plan (L68)

We serve members through many different plans, including HMSA’s Medicare Advantage members. This gives you the opportunity to see more patients and to provide much-needed dental care to seniors.

Frequently Asked Questions

Am I in-network for HMSA’s Akamai Advantage Dual Care?

Effective 1/1/22 we have a limited HMSA Medicare Advantage network. You can verify your current participation status for this network by using the Find a Dentist portal. Simply enter the dentist’s name, select “All Islands,” and choose “Akamai Advantage Dual Care PPO SNP” from the drop-down menu for “Select Plan Name.”

How do I verify my patients’ Medicare Advantage status?

Members will present to your office with a HMSA PPO Dual Care (PPO SNP) ID card. To verify benefits, please refer to MyPatientsBenefits or contact Customer Service at 808-948-6000 Option 3. You can find samples of the benefit plans and member ID cards in our Medicare Advantage Dental Manual.

If a service isn’t covered by a member’s Medicare Advantage benefit plan, you are required by law to inform members in writing and in advance of treatment, outlining their financial responsibility.

How am I reimbursed for Medicare Advantage plans?

The Medicare Advantage fee schedules correspond to the PPO fee schedules.

What if I have opted out of Medicare?

If you have opted out of participation with Medicare, you are prohibited from providing services to Medicare members. If you provide services, you will not be reimbursed by Hawaii Medical Service Association. In addition, you are required by law to inform members in writing, and in advance of treatment, that you do not participate and they will be responsible for all charges.

Do I need to do any special training for Medicare Advantage?

Yes, all providers who participate with Medicare Advantage may adopt to complete fraud, waste and abuse training annually. This training is provided by the Centers for Medicare & Medicaid Services (CMS) to access it:

  • Visit CMS’s training site
  • Go to “Fraud and Abuse-related Resources”
  • Click on “Fraud and Abuse Educational Products”
  • Follow the instructions for accessing the web-based training and downloadable PDF versions

Once you have completed the required training, please complete the necessary form(s) and return it to DentalProviderRelations@bshi.net.

Where can I find more information?

You can find more information, including ID card examples, in our Medicare Advantage Dental Manual.