How to become a Medicaid provider in Hawaii
To bill Hawaii Medicaid, enroll through HOKU provider enrollment system, run by Med-QUEST's 2010 general-information manual names Affiliated Computer Services. The process has 5 steps, listed below with the documents the state asks for.
- Enrollment portal
- HOKU provider enrollment system
- Steps
- 5
- Documents
- 5
- Plans listed
- 5
On this page
Hawaii Medicaid enrollment at a glance
To bill Hawaii Medicaid, enroll through HOKU provider enrollment system, run by Med-QUEST's 2010 general-information manual names Affiliated Computer Services. The process has 5 steps, listed below with the documents the state asks for.
- Program
- Hawaii Medicaid — Med-QUEST Division (QUEST Integration)
- Enrollment portal
- HOKU provider enrollment system
- Fiscal agent
- Med-QUEST's 2010 general-information manual names Affiliated Computer Services (ACS), a Xerox company, as fiscal agent; we found no newer Med-QUEST statement
- Application fee
- Med-QUEST's HOKU FAQ describes an application fee ($500 at the time it was written) charged at initial enrollment and at revalidation, temporarily waived during the COVID-19 emergency. The provider-type list shows which types need a site visit and/or fee (e.g., home health agencies need both). Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
- Fingerprinting
- Med-QUEST runs fingerprint-based criminal history record checks (state repository and FBI), combined with Adult Protective Services and Child Abuse and Neglect registry checks, for certain provider requirements. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.
- Site visit
- Med-QUEST's provider-type requirements list says which provider types get a site visit (for example, home health agencies). Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.
- Revalidation
- Med-QUEST began revalidating all providers in 2017 and requires revalidation every five years. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.
- Provider manual
- Provider manual
Steps
- Create a HOKU username and password, then log on to HOKU
- Complete the enrollment application in HOKU (paper DHS 1139 applications are also accepted by email, fax or mail)
- Attach the NPI confirmation and any provider-type attachment (DHS 1139A-F, e.g., psychiatry/psychology credentialing, home health, hospitals, nursing facilities, ICF-IID)
- Pay the application fee and complete a site visit/background check if the provider type requires them
- To serve QUEST Integration members, contract with each health plan
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Most Hawaii Medicaid services are delivered through five QUEST Integration health plans that cover medical care and long-term services and supports. Providers enroll with Med-QUEST (HOKU) and contract with each plan they want to join. Med-QUEST's pages do not describe any centralized or shared credentialing. Centralized credentialing: not described; appears plan by plan.
- Plans (state list)
- AlohaCare
- HMSA
- Kaiser Permanente
- 'Ohana Health Plan
- UnitedHealthcare Community Plan
Frequently asked questions
How do I become a Medicaid provider in Hawaii?
To bill Hawaii Medicaid, enroll through HOKU provider enrollment system, run by Med-QUEST's 2010 general-information manual names Affiliated Computer Services. The process has 5 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Hawaii Medicaid?
Med-QUEST's HOKU FAQ describes an application fee ($500 at the time it was written) charged at initial enrollment and at revalidation, temporarily waived during the COVID-19 emergency. The provider-type list shows which types need a site visit and/or fee (e.g., home health agencies need both). Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
How often must Hawaii Medicaid providers revalidate?
Med-QUEST began revalidating all providers in 2017 and requires revalidation every five years. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.