HealthPro News
A monthly publication for participating HMSA health care providers, facilities, and their staff.
December 2014
ADMINISTRATION & NEWS
What’s
Inside
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On January 1, 2015, a new online prior authorization and referral feature
called iExchange will be available to you via the Hawaii Health Information
Network (HHIN) or Cozeva.
Pharmacy
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Aerial iExchange is a two-way communications platform to create, update,
and process prior authorization and referral transactions. iExchange provides
the following benefits:
Coding & Claims
3
• Real time entries – Get the Request ID (also referred to as the auth
ID) once the request has been submitted.
Plans
4
• Real time approvals – Get immediate responses based on
information entered.
Programs
6
• Online status of preauthorization and referral requests – Your staff may
check the status of requests that have been submitted.
Policy News
6
• Submission of documents – You can attach relevant information from
your patient’s medical records with the request. Acceptable file types
include digital images (e.g., jpg), pdf, and Word documents.
Calendar
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• Savings – Reduce time and expense associated with paper,
telephone, and fax processes.
iExchange will accept prior authorization requests for all HMSA member
plans except FEP.
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Commercial QUEST
iExchange: The Online Prior Authorization and QUEST Integration
Referral Tool
Medicare
To access this new feature, the following system requirements must
be met:
• Access to HHIN or Cozeva.
- For help logging on to HHIN, call 948-6446 on Oahu or
1 (800) 760-4672 toll-free on the Neighbor Islands.
- For help logging on to Cozeva, call 1 (888) 448-5879 toll-free,
Monday through Friday, 8 a.m. – 5 p.m. Hawaii time.
• Internet browsers: Mozilla Firefox, Safari, or Internet Explorer
(6.0-9.0).
To learn about opportunities to train on iExchange, email PSInquiries@
hmsa.com.
818 Keeaumoku St.
(808) 948-6330
An Independent Licensee of the Blue Cross and Blue Shield Association
P.O. Box 860
Honolulu, HI 96808-0860
hmsa.com
hhin.hmsa.com
Provider Resource Center
hmsa.com/portal/provider
1100-1333
Hawai‘i Medical
Service Association
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December 2014
Use HMSA’s Electronic Transactions
Save time and money with these electronic services:
• HHIN: Verify member eligibility, benefits, and claim status.
• eClaims: Submit claims online.
For more information, contact the ETS Outreach team at 948-6255 on Oahu or at ETSOutreach@hmsa.com.
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Tiered Copayments for HMSA’s 2015 ACA HMO Plans
Beginning January 1, 2015, many of HMSA’s Affordable Care Act (ACA)- compliant HMO plans will have tiered
copayments for physician visits. Members will have a difference in copayments for physician visits rendered by a PCP
versus a specialist; specialist visits will have a higher copayment than PCP visits. Please verify benefits before your
patients’ visits so that you can collect the correct copayment.
PHARMACY
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Nexium: Medicare Part D Formulary
Nexium® (esomeprazole) will remain a tier 3 (preferred brand) medication in 2015. This is a correction of information
previously posted on our website.
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Nexium: Commercial Formulary
Effective January 1, 2015, Nexium will move from a tier 2 (preferred brand) drug to a tier 3 (other brand) drug AND
require a step therapy trial with a generic proton pump inhibitor first. First-step generic agents include lansoprazole
(generic Prevacid), omeprazole (generic Prilosec), pantoprazole (generic Protonix), and rabeprazole (generic Aciphex).
Your patients who continue using Nexium without trying a generic agent first will be required to pay in full for
their medication.
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Insulin Tier Change
In the October 2014 HealthPro News, we provided a matrix showing a tier change for insulin products effective
January 1, 2015. However, we will not be moving forward with this change. We apologize for any confusion or
inconvenience this may have caused.
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December 2014
CODING & CLAIMS
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Submitting Documentation with Claims
There are times when HMSA needs supporting documentation to process a claim. In these cases, supporting
documentation must be attached to the specific claim that it supports. You can’t submit one set of supporting
documentation for a group of claims. You can submit either one multi-page claim with one set of attachments or
individual claims with supporting documentation attached to each claim. We can’t accept multiple separate claims
with one set of supporting documents.
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Office Urine Drug Screening Tests
HMSA conducts post-payment reviews to ensure that claims are submitted and processed according to the right
coding guidelines and policies. Recently, we found that some providers are submitting incorrect CPT or HCPCS codes
on claims for urine drug screenings in the office setting with multiplexed screening kits (or cassettes, cups, etc.).
HMSA will recoup payments made for claims with incorrect codes.
Since 2011, the CPT book published by the American Medical Association (AMA) has stated, “For qualitative analysis
by multiplexed screening kit for multiple drugs or drug classes, use CPT 80104.” The definition says the code should
be billed once for each procedure:
•C
PT 80104: Drug screen, qualitative, multiple drug classes other than chromatographic method,
each procedure.
Medicare Advantage plans follow CMS guidelines, which only allow HCPCS code G0434 to be billed when using
multiplexed screening kit. The G0434 should be billed as one unit when reported:
•H
CPCS G0434: Drug screen, other than chromatographic, any number of drug classes, by CLIA waived test or
moderate complexity test, per patient encounter.
Please refer to the following CMS link: cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/
MLNMattersArticles/downloads/SE1105.pdf.
Based on these definitions, CPT code 80104 and HCPCS G0434 are equivalent and should be reported as one unit
each. HMSA’s non-Medicare plans accept both codes. This is a reminder that when your office performs urine drug
screening tests using multiplexed screening kits (or cassettes, cups, etc.), the appropriate code to bill is either CPT
80104 or G0434 for one unit.
In addition, remember to bill the QW modifier when tests performed in the provider’s office are FDA-approved
waived tests under the Clinical Laboratory Improvement Amendments (CLIA). Based on CLIA Law and Regulation
requirements, when rendering lab services in the office setting, the appropriate CLIA certification documentation
should be available in your office.
NOTE: 80104 will be terminating on December 31, 2014. Effective January 1, 2015, a new code should be used to
report the office urine drug screening tests:
•C
PT code 80300: Drug screening, any number of drug classes from Drug Class Lists A, any number of nonTLC devices or procedures, capable of being read by direct optical observation, including instrumented-assisted
when performed, per date of services.
CPT code 80300 should be billed as one unit per patient, per day.
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December 2014
PLANS
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QUEST Integration
The new benefit year begins January 1, 2015, and brings a new plan, QUEST Integration, which combines the QUEST
population and the QUEST Expanded Access (QExA) population into a single plan.
There’s no change to the benefits that were available to these members under their previous QUEST or QExA plan.
Members who opted to change plans for the new benefit year will have a seamless transition of care from the
previous plan to the new plan. Any treatment plan approved by the previous plan may continue during the transition
until the treatment plan is completed or the new PCP has had an opportunity to review the treatment plan.
New HMSA membership cards will be sent to all members. Members are now classified into three categories as
noted under the Benefit field on their new HMSA card.
NON-ABD: These are members who are not aged, blind, or disabled. They were previously QUEST members and
continue to be eligible for regular QUEST benefits for adults and children.
QUEST INTEGRATION
Member Name
KEIKI K QUEST
Member ID
XLQ1234567890
Effective Date
Benefit
11/05/14
NON-ABD
Birth Date 08/05/07
Sex M
PCP KIMO U MAHALO MD
Network BIG ISLAND FAMILY
PRACTICE
PCP Phone (808) 123-4567
PCP Effective Date 9/16/14
TPL1 HMSA HEALTH PLAN HI
TPL2
RXBIN 004336
RXPCN ADV
RXGRP RX3987
EPSDT
Member: This is your QUEST identification card.
Present it to the provider of health care when you
receive services. Please call HMSA if you have
questions regarding your benefits.
Providers: This is a QUEST member. QUEST is
the state of Hawaii Medicaid Managed Care
Program. Payment of benefits will be based on
the patient’s eligibility at the time services are
received.
For pharmacy services rendered in Hawaii,
mail claims to: Pharmacy Claims, P.O. Box 52116,
Phoenix, Arizona 85072-2136.
For all other services rendered in Hawaii, mail
claims to: The HMSA Plan for QUEST Members Claims, P.O. Box 3520, Honolulu, HI 96811-3520
Services rendered out-of-state, mail claims to:
The local Blue Cross/Blue Shield of the service
area.
hmsa.com
24 Call Center
and Nurseline
Oahu 948-6486
Toll-free 1 (800) 440-0640
Blue Cross Blue Shield of Hawai‘i
818 Keeaumoku St.
Honolulu, HI 96814-2365
An Independent Licensee of the
Blue Cross and Blue Shield Association
ABD: These are members who are aged, blind, or disabled. They were previously QUEST Expanded Access (QExA)
members and continue to be eligible for regular QUEST benefits as well as the expanded benefits under their
previous QExA plan.
QUEST INTEGRATION
Member Name
KIMO K QUEST
Member ID
XLQ1234567890
Effective Date
Benefit
11/05/14
ABD
Sex M
Birth Date 07/04/86
PCP KIMO U MAHALO MD
Network BIG ISLAND FAMILY
PRACTICE
PCP Phone (808) 123-4567
PCP Effective Date 9/16/14
TPL1
TPL2
RXBIN 004336
RXPCN ADV
RXGRP RX3987
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Commercial QUEST
Medicare
Member: This is your QUEST identification card.
Present it to the provider of health care when you
receive services. Please call HMSA if you have
questions regarding your benefits.
Providers: This is a QUEST member. QUEST is
the state of Hawaii Medicaid Managed Care
Program. Payment of benefits will be based on
the patient’s eligibility at the time services are
received.
For pharmacy services rendered in Hawaii,
mail claims to: Pharmacy Claims, P.O. Box 52116,
Phoenix, Arizona 85072-2136.
For all other services rendered in Hawaii, mail
claims to: The HMSA Plan for QUEST Members Claims, P.O. Box 3520, Honolulu, HI 96811-3520
Services rendered out-of-state, mail claims to:
The local Blue Cross/Blue Shield of the service
area.
hmsa.com
24 Call Center
and Nurseline
Oahu 948-6486
Toll-free 1 (800) 440-0640
Blue Cross Blue Shield of Hawai‘i
818 Keeaumoku St.
Honolulu, HI 96814-2365
An Independent Licensee of the
Blue Cross and Blue Shield Association
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December 2014
PLANS (CONTINUED)
ABD and LTSS: These are ABD members who are eligible for the same medical benefits as the ABD population
and long-term supports and services (LTSS), including non-medical services such as expanded adult residential care
home, community care foster family home, personal assistance, and other services that support a medical condition.
QUEST INTEGRATION
Member Name
KIMI K QUEST
Member ID
XLQ1234567890
Effective Date
Benefit
11/05/14
ABD and LTSS
Sex F
Birth Date 03/05/87
PCP KIMO U MAHALO MD
Network BIG ISLAND FAMILY
PRACTICE
PCP Phone (808) 123-4567
PCP Effective Date 9/16/14
TPL1 HMSA HEALTH PLAN HI
TPL2
RXBIN 004336
RXPCN ADV
RXGRP RX3987
Member: This is your QUEST identification card.
Present it to the provider of health care when you
receive services. Please call HMSA if you have
questions regarding your benefits.
Providers: This is a QUEST member. QUEST is
the state of Hawaii Medicaid Managed Care
Program. Payment of benefits will be based on
the patient’s eligibility at the time services are
received.
For pharmacy services rendered in Hawaii,
mail claims to: Pharmacy Claims, P.O. Box 52116,
Phoenix, Arizona 85072-2136.
For all other services rendered in Hawaii, mail
claims to: The HMSA Plan for QUEST Members Claims, P.O. Box 3520, Honolulu, HI 96811-3520
Services rendered out-of-state, mail claims to:
The local Blue Cross/Blue Shield of the service
area.
hmsa.com
24 Call Center
and Nurseline
Oahu 948-6486
Toll-free 1 (800) 440-0640
Blue Cross Blue Shield of Hawai‘i
818 Keeaumoku St.
Honolulu, HI 96814-2365
An Independent Licensee of the
Blue Cross and Blue Shield Association
Please verify QUEST Integration enrollment at each visit. You should confirm eligibility and note which QUEST
Integration plan they are enrolled in, as well as PCP information. You can continue to confirm HMSA QUEST
Integration eligibility by using HHIN or calling QUEST Integration Provider Service at 948-6486 on Oahu or
1 (800) 440-0640 toll-free on the Neighbor Islands. If you’re registered with the state’s online system, you can
also access the Med-QUEST eligibility website.
Thank you for your past partnership with HMSA’s QUEST plan. We look forward to your continued collaboration in the
new QUEST Integration plan.
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QUEST Integration Informational Session Available Online
The QUEST Integration Informational Session held November 19, 2014, is available online to view at your
convenience. To view the session, visit the HMSA Provider Resource Center.
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Multiple ER Visits on the Same Day
When the same patient is seen in the emergency room at different times on the same day, be sure to provide the
visit times. Otherwise, one of the visits will be denied as a duplicate claim. On paper claim submissions, use the
remarks form locator 80 to indicate that the patient was seen twice on the same day and include the time for the
billed visit. On electronic claims, use the notes field to provide the information.
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Well-woman Visits
As a reminder, women may self-refer to a women’s health specialist for well-woman exams. No referral is needed
unless the visit will be to a specialist on an island other than the member’s island of residence.
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December 2014
PROGRAMS
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Aloha Kidney
Aloha Kidney is a program created by local nephrologist and HMSA Medical Director Ramona Wong, M.D., as a
community outreach effort. The two components of the program are kidney disease education and chronic kidney
disease navigation.
The goal of this program is to help patients understand how to slow the loss of kidney function, reduce CV risks,
explore all options if kidneys fail, and prepare in time to smooth any transitions, enabling them to make informed
choices and work better with their doctors.
Dr. Wong personally provides kidney disease education through an ongoing series of six free classes, two hours
each, for patients and their families. She provides chronic kidney disease navigation as a free service to doctors and
their office staff, and chronic kidney disease patients and their families when patients need help getting to the next
step aligned with their life goals.
HMSA has become a co-sponsor of Aloha Kidney, collaborating with Dr. Wong to expand awareness of and access
to these educational sessions. HMSA hired Ku'ulei Alama Francis, R.N., who has years of experience in CCU, ICU,
palliative care, hospice, and CKD/ESRD disease management. She’ll work with Dr. Wong as an additional chronic
kidney disease navigator for HMSA members.
The process is simple. Any patient with a GFR<60 or proteinuria can call 585-8404 on Oahu to register for classes.
Aloha Kidney classes are currently offered in three locations on Oahu and via the Web to Neighbor Island residents.
Providers who want individualized chronic kidney disease navigation for a patient who’s having a difficult time can
also call.
It’s our hope that you, your patients with chronic kidney disease, and their families will benefit from the expertise
offered by this collective effort. Call 585-8404 on Oahu to request brochures, services, or more information.
POLICY NEWS
Medical policies are at hmsa.com/prc0004. For copies, call Provider Services at 948-6330 on Oahu or
1 (800) 790-4672 toll-free on the Neighbor Islands.
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Expanded Coverage of Polysomnography/Sleep Studies
HMSA will soon be covering polysomnography in the home setting. The draft policy is available for review at hmsa.
com/prc0005 and becomes effective March 1, 2015. This broader coverage of polysomnography is for members who
do not have contradictions to a home study, such as high blood pressure, heart disease, history of stroke, other
breathing disorders, etc. Facility-based studies are available as previously published.
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POLICY NEWS (CONTINUED)
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Provider Input Solicited for Annual Policy Review – December
HMSA’s medical directors welcome comments and suggestions from participating providers about medical policies
that are undergoing annual review.
We’re soliciting input for these policies:
• Anesthesia for Gastrointestinal Endoscopies.
• Bio-Engineered Skin and Soft Tissue Substitutes.
• Blepharoplasty and Repair of Blepharoptosis.
• Bortezomib (Velcade).
• Computerized Corneal Topography.
• Cosmetic and Reconstructive Surgery and Services.
• Endovascular Procedures for Intracranial Arterial Disease.
• Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes.
• Implantable Ventricular Assist Devices and Total Artificial Hearts.
• Intrastromal Corneal Ring Segments for Keratoconus.
• Panniculectomy/Abdominoplasty.
• Photodynamic Therapy for the Treatment of Actinic Keratoses and Other Skin Lesions.
• Reduction Mammaplasty.
• Repetitive Transcranial Magnetic Stimulation for Treatment of Refractory Depression.
• Spinal Cord Stimulators for Pain Management.
• Transcatheter Closure of Patent Foramen Ovale for Stroke Prevention.
• Transcatheter Pulmonary Valve Implantation.
• Transcutaneous Electrical Nerve Stimulation (TENS).
• Treatment of Varicose Veins.
• Uterine Artery Embolization to Treat Fibroids.
Go to hmsa.com/prc0005 to read these policies. Please include supportive citation source material when submitting
comments to help medical directors evaluate the comment or proposed change.
We can’t guarantee that any specific proposed change will be included in the final policy. Our policies rely on the use
of evidence-based medicine, typically from peer-reviewed literature.
You may comment by email to medical_policy@hmsa.com or by fax to 944-5611 on Oahu. Comments are due by
December 31, 2014.
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New Policy Drafts Online for Review
Drafts of new medical policies are posted online for your review. Please visit hmsa.com/prc0005 in the Provider
E-Library for drafts of policies that may affect your practice.
Please comment by the due date indicated to medical_policy@hmsa.com or by fax to 944-5611 on Oahu.
Questions? Call Provider Services at 948-6330 on Oahu or 1 (800) 790-4672 toll-free on the Neighbor Islands.
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POLICY NEWS (CONTINUED)
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Annual Review of Medical Policies
The following policies have undergone review and have been updated in the Provider E-Library at
hmsa.com/prc0006; printed copies are available on request.
• Allogeneic Hematopoietic Stem-Cell Transplantation for Genetic Diseases and Acquired Anemias.
• Biological Agents for the Treatment of Plaque Psoriasis.
• Biomarkers (Novel) in Risk Assessment and Management of Cardiovascular Disease.
• Bone Mineral Density.
• Carotid Artery Stenting.
• Colorectal Cancer Screening.
• Continuous Glucose Monitoring System.
• Erythropoiesis Stimulating Agents (ESA).
• High Frequency Chest Wall Oscillation Devices.
• Home Infusion Pain Management Therapy.
• Negative Pressure Wound Therapy (NPWT).
• Never Events and Hospital Acquired Conditions.
• Pulse Oximeters for Children.
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90-Day Notice for Policy Changes
The following policies have been updated and are effective March 1, 2015. Revisions can be found at the
accompanying URL.
• Colonoscopy: The criteria/guidelines and references. hmsa.com/portal/provider/zav_pel.aa.COL.301.htm
• Endovascular Procedures (Angioplasty and/or Stenting) for Intracranial Arterial Disease (Atherosclerosis
and Aneurysms): The description, criteria/guidelines, administrative guidelines, and references.
hmsa.com/portal/provider/zav_pel.aa.END.100.htm
• Immune Globulin Therapy: The criteria/guidelines and references.
hmsa.com/portal/provider/zav_pel.aa.INT.701.htm
• Insulin Pumps – External: The criteria/guidelines and references.
hmsa.com/portal/provider/zav_pel.aa.INS.501.htm
• Intensity Modulated Radiation Therapy (IMRT): The criteria/guidelines, administrative guidelines, and
references. hmsa.com/portal/provider/zav_pel.aa.INT.201.htm
• Polysomnography and Sleep Studies: The criteria/guidelines, limitations/exclusions, administrative guidelines,
and references. hmsa.com/portal/provider/zav_pel.aa.POL.501.htm
• Readmissions and Transfers: The administrative guidelines and references.
hmsa.com/portal/provider/zav_pel.aa.REA.401.htm
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New Policies
The following policy goes into effect December 1, 2014.
• Ledipasvir/Sofosbuvir (Harvoni) for Treatment of Hepatitis C.
Precertification is required through CVS/Caremark. We encourage you to read the criteria.
Please refer to the current medical policies online for more information, including precertification requirements,
at hmsa.com/prc0006. C QM
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CALENDAR
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Hawaii State License Renewal Reminder
Hawaii state licenses for physical therapists (PT) and occupational therapists (OT) will expire on December 31, 2014.
We encourage you to renew your license as soon as possible. We’ve been advised that there’s a time lag
between renewing a license and posting the renewal on the state’s licensing website, which we reference for
current licensure.
To update our records, we ask that PTs and OTs submit a copy of their renewed license to HMSA’s Credentialing
Unit by one of the following methods:
• Fax to 948-8212 on Oahu.
• Email to ps-credunit@hmsa.com.
• Standard mail:
HMSA
Attn: Credentialing Unit, Room 550C
P.O. Box 860
Honolulu, HI 96808-0860
If we can’t confirm that you renewed your state license, we’re required to terminate your HMSA credentialing status.
This may result in HMSA being unable to make payments for your services effective January 1, 2015.
If you have questions, please call the Credentialing Unit at 948-5010 on Oahu or 1 (800) 603-4672, ext. 5010, toll-free
on the Neighbor Islands.
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Well-Being Workshops
The workshops listed below are available to HMSA members at no cost. These informative sessions are presented
by Healthways health educators and can help your patients improve their health and well-being.
For more information, refer your patients to hmsa.com/wellness-programs/workshops or have them call
1 (855) 329-5461 toll-free to register.
Goodbye, Diet! Hello, Health!
Season’s Eatings
Learn how to reach your weight-loss goals with good
nutrition, regular exercise, and other healthy behaviors.
Discover strategies to maintain your health and weight
during the tempting holiday season.
• 12/5, 4:30–5:30 p.m.
HMSA Center @ Honolulu
• 12/12, 10–11 a.m.
HMSA Center @ Pearl City
Exercise: the Magic Bullet
Music & Health Christmas Special
Learn fun and convenient ways to be more active.
Music, singing, and laughter are just plain good for us.
Find out why and recapture those moments that make
Christmas memorable.
• 12/6, 9:30–10:30 a.m.
Kaimuki Plaza, Kaimana Room
• 12/13, 9:30–10:30 a.m.
Kaimuki Plaza, Kaimana Room
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CALENDAR (CONTINUED)
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Community Classes
Walk With a Doc on Hawaii Island
Adult Fitness at Queen’s
Meet up, rain or shine, for some beneficial, lowimpact exercise. Walk includes a brief warm-up/stretch
and an informative talk from a community doctor or
medical student. First-time walkers get a free T-shirt
and pedometer. For more information, see
wwadbigisland.org.
The Queen’s Medical Center, Women’s Health Center
Classroom. Six classes for $66. Call 691-7117 to register.
• Every Sunday, 8 a.m.
Liliuokalani Gardens, Hilo
Health & Education at Queen’s
The Queen’s Medical Center, Women’s Health
Center Classroom.
•G
enetics Class: Learn about prenatal genetic
screening and tests to check the health of your
baby. Call 691-7633 for times and information. Free.
•L
amaze Class: Sundays, 1–4 p.m. Get birthing
techniques from a Lamaze-certified instructor in
this birth-partner-focused class. $150 per couple for
five sessions.
•L
ymphedema/Breast Cancer Clinic: First and
third Thursdays, 11:30 a.m.–12:30 p.m. Learn
exercises to prevent lymphedema (swelling of the
arms). Free.
•M
ammogram and Cervical Cancer Screening:
Every other Friday, 8 a.m.–noon. Free for women
who are ages 50–64, uninsured or underinsured,
or low income. Call 691-7726 for times and
eligibility information.
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• Pilates and Yoga with Fitness Cue: Mondays,
noon–1 p.m. Strengthen and lengthen muscles and
improve spinal health and alignment. Instructor:
Li Si Yang.
• Bollywood and Beyond: Tuesdays, 4:30–5:30 p.m.
Perform upbeat and expressive movements from
around the world. Instructor: Willow Chang.
• Journey to Fitness Pyramid: Wednesdays,
noon –1 p.m. Learn corrective exercises and five
principles of good health and fitness. Instructor:
Li Si Yang.
• Kickboxing Fitness: Thursdays, 6–7 p.m. Tone
your body using mitts, kick pads, and standing
heavy bags. Instructor: Mineyo Shimojo.
• Jazzercise: Fridays, noon –1 p.m. Dance-based
cardio and strength training. Instructor:
Sheri Yamashita.