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Get and Sign Dhs 1139 Form 2014-2022

Get and Sign Dhs 1139 Form 2014-2022

Get the hawaii medicaid request 2014 template, fill it out, eSign it, and share it in minutes.

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 MANAGED CARE MQD has been able to obtain a waiver from some of the requirements for providers of managed care health plans. Managed care health plans will perform credentialing of...
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