Hawaii Application Service Provider Agreement

State:
Multi-State
Control #:
US-CP1027-AM
Format:
Word; 
Rich Text
Instant download

Description

This sample form, a detailed Application Service Provider Agreement document, is for use in the computer, internet and/or software industries. Adapt to fit your circumstances. Available in Word format.
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FAQ

The Medicaid FFS Program is the traditional Medicaid Program that has provided medical coverage to low-income Hawaii residents since January 1966. The program provides coverage for individuals who are age 65 and over, or under age 65 who are blind or disabled.

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.

The Department of Human Services is the single State agency designated to administer the Hawaii Medicaid program under Title XIX of the Social Security Act.

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

HOKU, in Hawaiian, means guiding star. Kahu, in Hawaiian, means caretaker or pastor or one who looks after their flock.

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Hawaii Application Service Provider Agreement