Bureau of Health Care Financing Administration

 

Administers and oversees the following Health Service Programs:

  • Medicaid Assistance Program (MAP)
  • Medically Indigent Program (MIP)

Inside the Bureau of Health Care Financing Administration

  • Program Management Section

    The Program Management Section is responsible for the financial and program management support; development, monitoring & evaluation of the program state plan, policies and procedures, operations, manuals, and rules and regulations.

  • Operations Section (Benefits Coordination/Claims Processing)

    The operations section oversees the utilization control and claims processing unit, off-island referral coordination, and the benefit support unit.

  • Quality Management Section

    The Quality Management Section is responsible for maintaining and developing the quality management of the Operation & Program Management Section.

  • Prior Authorization

    The Prior Authorization section is responsible for the issuance of Prior Authorization of the medical services.

  • Claims Intake

    The Claims Intake Section is responsible for the intake of claims from participating providers.