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  • Authorization To Disclose Protected Health Information - Alohacare

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AUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATION NOTE: Please read through all sections carefully. All fields marked with an asterisk (*) must be completed or this form cannot be processed.

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We are mission driven to care for people who are underserved with specific health needs. We provide health care coverage for Hawaii's QUEST Integration (Medicaid) beneficiaries. AlohaCare is a health plan with a Medicare contract and provides Medicare coverage to beneficiaries in Hawaii.

AlohaCare is a community-led, non-profit health plan founded in 1994 by Hawai`i's community health centers and is the only local health plan solely dedicated to serving those eligible for Hawai`i's QUEST Integration Medicaid and Medicare program. For more information, visit alohacare.org.

If you have questions, call us at 1-877-973-0712 toll free or email memberhelp@alohacare.org. We care and are here for you. Nurses and/or social workers can speak with you directly and help you get the care you need.

AlohaCare - Prior Auth Requirement. Make sure AlohaCare has your current address/phone number. Call us at 1-877-973-0712 if you have any questions.

Call us at 1-877-973-0712 if you have any questions.

Created in 1994, AlohaCare is a local, not-for-profit, community-governed Health Plan offering Medicaid and Medicare Advantage Plans statewide. We are the 2nd largest QUEST Integration plan and the 3rd largest health plan in Hawai'i.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232