Blue Cross Blue Shield

How to Get Credentialed with Hawaii Medical Service Association in Hawaii

Network: Open
60-120 Days

Quick Overview

Timeline

60 - 120 days

CAQH

Not Required

Re-credentialing

Every 3 year(s)

Delegated

No

Hawaii-Specific Requirements

Hawaii Medical Service Association (HMSA), the BCBS licensee for Hawaii. May not use CAQH ProView; HMSA uses Verisys for primary source verification. Providers should apply directly through HMSA's provider enrollment portal. Typical processing timeline: 60-90 days. Requires active Hawaii medical license from the Hawaii Medical Board. DEA registration required. Board certification required for specialists. Hawaii's Prepaid Health Care Act creates unique insurance requirements in the state. Delegated credentialing available through select groups. HMSA covers approximately 50% of Hawaii residents. Re-credentialing every 3 years.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Hawaii.

2

Prepare Your Application

Complete Hawaii Medical Service Association's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Hawaii Medical Service Association.

4

Track & Follow Up

Credentialing typically takes 60-120 days. Monitor your application status and respond promptly to requests for additional information.

Free Consultation

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Our specialists handle the entire Hawaii Medical Service Association enrollment process: applications, follow-ups, and approvals in Hawaii.

Required Documents Checklist

Board Certification

Conditional

Required if board certified; highly recommended

CV/Resume

5-year work history minimum; gaps > 6 months must be explained

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

3 peer references required

Key Credentialing Terms

CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Fee Schedule
A complete listing of fees and reimbursement rates that an insurance payer will pay for specific medical services and pr...
HMO
A Health Maintenance Organization is a managed care plan that typically requires members to choose a primary care physic...
Network Status
A provider's participation status with a specific insurance payer, indicating whether they are in-network (contracted) o...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
PPO
A Preferred Provider Organization is a managed care plan that offers a network of contracted providers at lower costs to...

Credentialing Checklist

Make sure you have everything ready before applying to Hawaii Medical Service Association.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

(866) 939-6013

Mon-Fri 8am-5pm

Provider Services

National

(866) 939-6013

Claims & Billing

National

(866) 939-6013

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Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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