hwmg (tpa)

Important Re-Credentialing Announcement

Dear Participating Provider:
 
To comply with the State of Hawaii's Act 192 mandating health care provider network adequacy and accreditation, HWMG is required to re-credential our participating providers, including contacting the primary source of certain credentials. Failure to re-credential may result in network termination. HWMG is the third-party administrator and local provider network for HMAA and self-insured clients.

If you have not done so in the last two years, providers must complete and submit a Credentialing Application and related documentation to HWMG through one of the following options in an effort to continue participation in our provider network. Your response within 30 days of this email will be greatly appreciated. 

If you are a group practice and unsure if your practitioners are credentialed, please email Credentialing@hwmg.org with their names and birthdates, and we will gladly let you know.
  • Option 2 - Application from other organization. A completed application used by another health insurer or entity may be accepted if deemed in accordance with our criteria. HWMG's Authorization, Attestation, and Release must also be signed and dated at the time of submission. Return a copy of the other entity's application, HWMG's authorization form, and supporting documentation to HWMG.
  • Option 3 - CAQH ProView. HWMG encourages the use of CAQH ProView (an online solution provided at no cost to you) to expedite the credentialing process.
    • If you are not yet registered with CAQH, you may register through their portal. Practitioners will receive a welcome email with an assigned CAQH ID and may login and follow the prompts to complete a profile and credentialing application. Once submitted, please email Credentialing@hwmg.org with the practitioner's assigned CAQH ID so we can add it to our roster.
    • If your practice uses CAQH, please ensure that the website is updated with your providers' most recent documents. HWMG will credential directly from CAQH, which will greatly reduce paperwork. Follow these steps to ensure your information is current, and email Credentialing@hwmg.org with your CAQH ID so we can add it to our roster.
  1. Login to CAQH ProView to update and/or re-attest to the profile at least once a year.
  2. Add new documents to replace any expired ones (e.g., current copy of liability insurance).
  3. Leave no gaps in work history for the most recent five years, or list reasons for any gaps.
  4. Allow Hawaii-Western Management Group (HWMG) to access the profile. 
You will be notified of any issues noted during review, which can take up to 90 days. Once we verify your information, we will present it for peer review by our Credentialing Committee (comprised of network physicians) and our Chief Medical Officer, and we will notify you of the outcome.

 
If you have any questions, please feel free to contact us Monday through Friday, 8 am to 4 pm HST. Mahalo for your cooperation with this important request!

For credentialing inquiries:
 
Credentialing
Phone (808) 791-7518
Toll-free (800) 621-6998 ext. 518
Fax (808) 535-8318
Credentialing@hwmg.org
For all other inquiries:
 
Provider Relations  
Phone (808) 791-7557
Toll-free (800) 621-6998 ext. 304 
Fax (808) 535-8314 

hwmg (tpa)

 

This announcement has been brought to you 

by HWMG Provider Connection.