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 Form 1139 Instructions 2014-2023

Form 1139 Instructions 2014-2023

Use a 1139 instructions 2014 template to make your document workflow more streamlined.

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 Health Care Services Branch, Provider Enrollment P. O. Box 700190 Kapolei, Hawaii 96709-0190 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 providers. The MQD is able...
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