Hmsa credentialing 2026

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4.8 out of 5

133 votes

The document is a credentialing application for facilities and ancillary providers seeking participation with the Hawai‘i Medical Service Association (HMSA). It requires detailed information about the facility, including legal and business names, contact details, medical director information, services offered, licensing status, Medicare participation, professional liability coverage, ownership disclosures, and compliance with Medicaid requirements. The application also includes sections for attestation of accuracy and dispute resolution procedures.

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Click ‘Get Form’ to open the HMSA Credentialing Application in the editor.
Begin with Section I: Facility Information. Fill in the Legal Name, Business Name (if applicable), Federal Tax Identification Number, and NPI. Ensure all fields are completed accurately.
Continue to provide contact details for the Administrator, including their email and phone number. Don’t forget to include the Medical Director's information if applicable.
In Section II, enter the Physical Address of your facility. Confirm if ADA accommodations are available by checking 'Yes' or 'No'.
Proceed to Section III for Mailing Address Information. This may differ from your physical address; ensure accuracy.
Complete Sections IV through XI as required, ensuring you attach any necessary documentation such as insurance certificates or accreditation letters.
Finally, review all entries for completeness and accuracy before electronically signing the form at the end.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (133 Votes)
2018	3.8 Satisfied (45 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What comes first, credentialing or privileging?

Credentialing is closely tied with privileging and is frequently a first step for physicians seeking hospital privileges.

What are the different types of credentialing?

Licenses and certifications are the two primary types of credentials. Credentials can also be earned via apprenticeships. Some state licensures may be earned by passing national exams.

What are the four main types of credentials for a career in health care?

What are the Main Types of Medical Credentials? Academic Degrees. Academic degrees represent the foundational education that healthcare professionals receive. Licensure. Board Certification. Professional Designations and Certifications. International Medical Credentials.

How long does the provider credentialing process take?

The credentialing process is a vital yet challenging aspect of healthcare that, if not managed effectively, can lead to docHub delays, frustration, and even financial losses.

What are the three types of credentialing?

Typical Credentialing Timelines On average, credentialing can take anywhere from 60 to 180 days, depending on factors like the complexity of the providers qualifications, the organization type, and specific payer requirements.

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How difficult is medical credentialing?

Individual physician credentialing costs between $100-$200 per physician. Most insurances and facilities require recredentialing every two years, which may vary. The CAQH Proview database is an option for online provider data collection.

What are three key pieces of information needed for credentialing?

Gathering provider information Credentialing begins with the collection of essential documents and data, including educational certificates, licenses, residency completion records, and work history.