Provider Contracting and Credentialing
Aloha and Welcome to our Provider Contracting and Credentialing Resource Page
Aligned with our Vision to improve healthcare through integration, innovation, and partnerships that value patient-centered care and clinician empowerment, MDX Hawaii credentials healthcare providers prior to participation in our network in compliance with NCQA standards.
Why should I join MDX Hawaii’s Provider Network?
Reach more patients: MDX Hawaii is the largest senior-focused IPA in the State of Hawaii. In addition to the Medicare population we serve through affiliations with Humana and United Healthcare (UHC), we also have a large Commercial population through arrangements with Aenta, Cigna HealthCare, Deseret Mutual Benefit Administrators (DMBA), Hygeia, and UHC.
Access to Multiple Health Plans: Through our delegated credentialing agreements with large national health insurers, a single credentialing process can be applied to multiple health plans. Through one credentialing process, providers will be credentialed locally with Aenta, Cigna HealthCare, Deseret Mutual Benefit Administrators (DMBA), Hygeia, Humana and UHC.
Streamlined application process using CAQH: If you already have a CAQH profile, we can access this in lieu of having you complete a separate application.
Partner with a quality-focused organization: Our credentialing process complies with the standards of the National Committee for Quality Assurance (NCQA).
Save Time and Reduce Costs: Submit claims electronically for faster processing and fewer administrative burdens.
Accelerate payments: Electronic Funds Transfer (EFT) ensures quick, secure reimbursements and lower administrative expenses.
Simplify daily operations: Through our Online Provider Portal, you can submit prior authorization requests, check claim and authorization status, and verify member eligibility, all in one convenient platform.
How do I sign up?
MDX Hawaii has partnered with Conifer Health Solutions to support several of our delegated services, including provider credentialing.
Signing up is easy! Simply email our Credentialing partner, Conifer Health Solutions at MDXHawaii@Coniferhealth.com with:
Your full name and NPI number
Group name (if applicable)
Practice demographic information
Tax ID
What happens after that?
We’ll confirm whether you are joining an existing contracted group or a new one.
If you’re joining an existing group, your credentialing can begin right away.
If you’re joining a non-contracted group, review and acceptance by our Contracting Team is required before credentialing begins. MDX Hawaii ‘s robust selection process is designed to create a high quality/high performing provider network to serve our membership.
As noted above, if you have an active CAQH profile, Conifer Health can access it directly. You won’t need to complete a full application form; some additional information may be needed, just respond promptly to any requests for additional information. Delays can impact credentialing timeliness.
Credentialing Timelines
Credentialing is typically completed within 30 to 45 days once all required information is received. Please respond quickly to any requests to avoid delays. Please contact us if your credentialing is taking longer than this.
Within two (2) weeks of approval, you’ll receive a Welcome Letter outlining next steps, along with a Provider Quick Reference Guide reflecting supported Health Plan partners.
When can I begin seeing patients?
Providers are considered Participating once they are both credentialed and contracted.
New provider contracts are usually effective at the first of the month after credentialing approval.
The contracting process may take an additional 30 – 60 days after your credentialing.
For providers joining an existing contracted group, participation typically begins the same day credentialing is approved.
What if I have additional questions?
For Questions Related to: | Contact: |
Credentialing Status | MDXHawaii@Coniferhealth.com |
Contract Status | Contracting@MDXHawaii.com |
General Questions other than Credentialing or Contracting (such as Customer Service, Claims inquiries, Authorization status, etc.) | Customer Service1-808-522-7500 From Oahu1-800-851-7110 Toll Free from the Neighbor Islands |