Not ready for online submission?  Access the new fillable DHS 8015/8016 here.

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Access the NEW fillable EPSDT 8015/8016 fillable ePDF. Click on the PDF icon to download the fillable ePDF. --------------------------------------------->

  • CLICK HERE to download the instructions for the 8015
  • CLICK HERE to download the instructions for the 8016.

You will need the Adobe Acrobat Reader or Adobe Acrobat to open and complete the form.  To access Adobe Acrobat, click here.

If printing forms, BOTH pages of the 8015 or 8016 must be printed and mailed with the CMS 1500 attached.  


Once you click to download, you will need to select to open the file in your "Open with system viewer" located on the bottom left of your browser.

EPSDT Providers can now set up new Med-QUEST Partner Portal accounts and then Onboard to EPSDT Online without delay!

Want to submit EPSDT visit data online?

Now Providers can use the self-service onboarding to get started in EPSDT Online.

What do I need to do?

All providers will need to follow the steps below:

  1. Make sure individual and billing Medicaid provider applications are completed, submitted and the individual providers associated to the billing provider in HOKU applications.
  2. Review this Quick Guide (attached) and video.
  3. Follow this link to register a new account on the Med-QUEST Partner Portal. Only enter information in fields with red asterisks.
  4. Complete the Partner Portal Account Multifactor Authentication (MFA) Setup.
  5. Follow this link back to the Med-QUEST Partner Portal page and login.
  6. Continue to follow the Quick Guide to onboard to EPSDT Online.

What if I have trouble setting up an account or onboarding to EPSDT Online?

If you have any questions or run into problems as you are onboarding, contact the EPSDT Helpdesk at:

(808) 900-8650 or email at [email protected]

How do I add my staff on EPSDT Online?

A provider must be the first one to initiate onboarding to EPSDT Online. This can be ANY Hawaii Medicaid enrolled Provider who’s HOKU application is associated to the clinic billing entity ID in HOKU. Once an individual provider is enrolled, all billing providers they are associated with on their HOKU application will automatically populate in EPSDT Online. To begin enrolling staff, the provider will need to indicate the billing entity that they would like to add staff to on EPSDT Online. All providers can add new provider support staff to EPSDT Online.

Can I assign a staff member to onboard the clinic staff?

Yes! EPSDT Online has a Business Manager role who you can assign to provide enrollment support. To protect patient health information, this role does not have access to EPSDT records, only clinic staff enrollment and disenrollment capability. All staff who need to input PHI in EPSDT online will need to be enrolled as Provider Support. If the Business Manager also needs to see patient records, they will need a separate login associated to a separate email address for a provider support login. Please note that Business Managers can only enroll provider support. They cannot enroll providers. All providers will need to follow the “what do I need to do” steps above.