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  • Dhs 1139c Instructions 2008

Get Dhs 1139c Instructions 2008-2025

A completed DHS 1139, Medicaid Application/Change Request Form. INSTRUCTIONS: 1. Print Name of Provider: Self Explanatory 2. Signature: Self Explanatory 4. Date Signed: Self Explanatory .

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Related content

DHS 1139C Form Instructions - Hawaii Medicaid
Form DHS 1139C shall be used by health care providers who provide home health services...
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Who is eligible for Hawaii Medicaid Fee-For-Service Program? Household Size*Maximum Income Level (Per Year)1$22,3052$30,1653$38,0254$45,8854 more rows

Be a New Provider Email:HCSBInquiries@dhs.hawaii.govPhone:1-833-909-3630Fax:808-692-8087Mailing Address:Med-QUEST Division Health Care Services Branch, Provider Enrollment 601 Kamokila Blvd., Room 506A Kapolei, Hawaii 96707

Call Med-QUEST Enrollment Services Section at 1-800-316-8005 toll-free, 7:45 a.m. to 4:30 p.m., Monday-Friday, except state holidays. TTY users, call 1-800-603-1201 toll-free. Have changes to report or health plan eligibility questions?

Med-QUEST Division was established in 1994 to administer the State's Medicaid program under title XIX of the Social Security Act. Throughout the years, the Medicaid program has changed from only Fee-For-Services (FFS) to a combination of Managed Care and FFS delivery system.

Hawaii State Department of Human Services, Med-QUEST Division requires all Medicaid Providers to register through the HOKU Provider Enrollment System prior to becoming a credentialed or contracted provider with any Health Plan. If you have not done so, please go to the Med-quest website to register. 808-692-8099.

Hawaii's Medicaid/CHIP is called Med-QUEST (QUEST stands for Quality care, Universal access, Efficient utilization, Stabilizing costs, and Transforming the way health care is provided to recipients).

Med-QUEST Division was established in 1994 to administer the State's Medicaid program under title XIX of the Social Security Act. Throughout the years, the Medicaid program has changed from only Fee-For-Services (FFS) to a combination of Managed Care and FFS delivery system.

Hawaii's Medicaid/CHIP is called Med-QUEST (QUEST stands for Quality care, Universal access, Efficient utilization, Stabilizing costs, and Transforming the way health care is provided to recipients).

Q. Can I use my Medicaid coverage in any state? A: No. Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your Medicaid coverage when you're temporarily visiting another state, unless you need emergency health care.

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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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