Health Care Services Branch, Provider Enrollment
601 Kamokila Blvd., Room 506A
Kapolei, Hawaii 96707
Med-QUEST Division is doing our part to help prevent the spread of COVID-19 while continuing our services. We encourage providers to avoid coming to our office and to utlize the three options above (email, fax and mail). If you prefer or are only able to drop off your app, a drop box is available in the lobby of our building to drop-off provider applications or change request forms. Please use the bin that says ‘Medicaid Provider Drop-off Bin.’
*Please create your HOKU username and password prior to clicking on the 'Logon to HOKU' link. Click here for instructions on how to setup your HOKU account and create your username and password.
Currently, all dental services are provided under the fee-for-service program, which covers dental services for Hawaii Medicaid recipients. (Previously dental services were part of the managed care program.) If you would like to be a dental provider or if you are already a provider and want to report changes you can use the HOKU websitelink above or fill out the revised Provider Enrollment Application (DHS 1139 Rev 11/2022).
You should enroll in HOKU or submit a new paper application if you:
Opened a new private practice
Were a Managed Care Provider
Are reactivating a Medicaid Provider number which was terminated more than one year ago.
If you are establishing a payee (pay to) other than your own social security number . A separate application must be submitted on behalf of the payee entity (e.g. XYZ, Inc or LLC).