All Hawaii Medicaid Electronic Submitters must complete new EDI Enrollment Forms along with an EDI Trading Partner Agreement before submitting X12N transactions. To access these forms, please click "EDI Enrollment" below to be redirected to the Hawaii Enrollment site.
To receive a Trading Partner ID and logon information, please complete and return the Enrollment Packet for Hawaii Medicaid.
For questions regarding the Conduent EDI Solutions, Inc. Enrollment Packet, please contact our Hawaii Provider Support Unit, Monday-Friday at:
- Toll Free (888) 333.5641
- Local (808) 952.5583
- Email: firstname.lastname@example.org
EDI Provider Enrollment Packet for X12N Transactions
This packet consists of the following documents: