What do we do

Koan Risk Solutions provides diversified healthcare and insurance services for the State of Hawaii. We are the third-party administrator of the Hawaii Medicaid SHOTT Program (State of Hawaii Organ and Tissue Transplant Program) and provide case management and authorization of payments for services rendered to Hawaii Medicaid recipients. Koan also provides Commercial Insurance risk management services to businesses in the State of Hawaii.

Hawaii Medicaid Ombudsman

Koan Risk Solutions was selected to provide Ombudsman services to Hawaii Medicaid beneficiaries and providers on all islands.  We can assist Medicaid beneficiaries and managed care providers resolve problems with their QUEST Integration health plans.

Hawaii Medicaid Beneficiary

As a Medicaid beneficiary, you may:

Have extensive or complex health care needs.

Have difficulty understanding how the managed care system works.

Have difficulty understanding how to access services and the limitations to your healthcare.

Not happy with the quality of care you are receiving.

We are here to assist and educate you about managed care, how to navigate through a managed care system to access needed health services and guide you through the grievance and appeal system.  We will assist you with issues related to access to care, quality of care, and limitation to care.

Managed Care Provider

Ombudsman Services provided by Koan Risk Solutions also include responding to and addressing concerns from managed care Providers.  We work with managed care Providers to help them understand the requirements of the managed care system and work with the QI health plans to informally resolve problems.  We are available to educate managed care Providers on how to access the provider grievance and appeals process of the managed care system and

shall assist managed care Providers with issues related to reimbursement, availability of services, quality of services, delivery of services, and limitations on services.

Contact Us

Hours of Operation: 7:45am-4:30pm Monday-Friday (Excluding Hawaii State Holidays)

Office Address*: 1580 Makaloa St. #550 Honolulu, HI 96814

By Phone-Toll Free: 1-844-844-2430

By Phone-Locally: 1-808-746-3324

By Email**: hiombudsman@koanrisksolutions.com

Inquirers who are Deaf or Hard of Hearing may access text-telephone (TTY) captioned telephone or Braille TTY  by dialing 1-877-447-5990 or 711.

Let us call you back! Please fill out the form below:

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    *By Appointment Only

    **Please note: E-mail provides no mechanism for ensuring the confidentiality or privacy of information contained within a message in transit. Therefore, the sender of an email message assumes responsibility for including confidential or private data when utilizing this communication medium. The sender should exercise caution when composing a message to exclude confidential or private information such as names, street addresses, phone numbers, social security numbers, license numbers, other personal identification numbers, etc.

    Need an Interpreter?  

    ATTENTION: If you don’t speak English, language assistance services, free of charge, are available to you.  Call 1-844-844-2430 (TTY: 1-877-447-5990 or 711).

     

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