Loading
Form preview picture

Get HI DHS 1139 Instructions 2014-2024

to the Med-QUEST Division’s (MQD) processing of provider applications for the fee-for-service (FFS) program. A list of these requirements is provided below. The MQD is required to obtain a $500 application fee from all providers EXCEPT for Physicians, Psychiatrists, Podiatrists, Optometrists, APRNs, Physician Assistants, RNs, and Dentists. Please submit a money order or cashiers check for $500 when submitting your application, payable to: State Director of Finance c/o Med-QUEST Division Healt.

How It Works

1902 rating
4.9Satisfied
310 votes

Tips on how to fill out, edit and sign Npi online

How to fill out and sign Kapolei online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

Experience all the key benefits of completing and submitting legal documents online. Using our platform submitting HI DHS 1139 Instructions only takes a couple of minutes. We make that achievable through giving you access to our full-fledged editor effective at changing/correcting a document?s initial text, inserting unique fields, and putting your signature on.

Execute HI DHS 1139 Instructions in a few moments by using the recommendations listed below:

  1. Pick the document template you will need in the collection of legal forms.
  2. Click on the Get form key to open it and start editing.
  3. Complete all the required fields (they are marked in yellow).
  4. The Signature Wizard will enable you to put your e-autograph right after you have finished imputing data.
  5. Add the relevant date.
  6. Check the whole form to make sure you have filled in everything and no corrections are needed.
  7. Hit Done and download the resulting document to your gadget.

Send your HI DHS 1139 Instructions in a digital form as soon as you finish completing it. Your information is well-protected, because we adhere to the most up-to-date security criteria. Become one of millions of happy users who are already submitting legal documents right from their apartments.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Video instructions and help with filling out and completing icf

Get your Form filled out and e-signed from the comfort of your home. This video guide helps you to prepare and handle legal documents remotely.

Legibly FAQ

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

Keywords relevant to HI DHS 1139 Instructions

  • cfr
  • SSA
  • 1902
  • credentialing
  • icf
  • SSN
  • legibly
  • FFS
  • npi
  • 2-digit
  • xviii
  • kapolei
  • clia
  • COINSURANCE
  • 5-digit
If you believe that this page should be taken down, please follow our DMCA take down processhere.
Ensure the security of your data and transactions

USLegal fulfills industry-leading security and compliance standards.

  • 
                            VeriSign logo picture

    VeriSign secured

    #1 Internet-trusted security seal. Ensures that a website is free of malware attacks.

  • Accredited Business

    Guarantees that a business meets BBB accreditation standards in the US and Canada.

  • 
                            TopTenReviews logo picture

    TopTen Reviews

    Highest customer reviews on one of the most highly-trusted product review platforms.