- 1-800-851-7110
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Makai Tower, Suite 3000, Honolulu, HI 96813
We Are Providing Best & Affordable Health Care
MDX Hawaii is pleased to announce it has executed an agreement with Conifer Health Solutions (Conifer) to provide MSO services for MDX’s Medicare line of business effective for dates of service January 1, 2024 and after.
24/7 Support
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Qualified Doctors
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Medicare Advantage Plans Contracted
Partnering and collaborating with a coordinated network of 630 top independent primary care physicians and over 2,300 leading specialists and hospitals
24/7 Support
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Qualified Doctors
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Scott Miscovich, M.D.
Award Winning PhysicianMDX Hawaii
Partnering and collaborating with a coordinated network of 630 top independent primary care physicians and over 2,300 leading specialists and hospitals in the state of Hawai‘i, MDX Hawai‘i is reimagining quality, efficiency, and patient experience by providing seamless care coordination to Humana and UnitedHealthcare Medicare Advantage patients.
Headquartered in Honolulu, MDX Hawai‘i has been in operations in Hawai‘i for more than 35 years.
Today, we care for over 40,000 Humana and UnitedHealthcare Medicare Advantage members.
- 2024 Accepted Medicare Advantage Plans
- Medicare Advantage Plans Contracted with MDX Hawai'i
- For services rendered Jan. 1, 2024 - Dec. 31, 2024
Claims and Encounter Submissions
For claims and encounters with dates of service on or after January 1, 2024, please submit claims and encounter data as follows:
| Electronic Submission | |
|---|---|
Clearinghouse |
Emdeon |
Payor ID |
95399 |
Support |
(866)575-4120 OR Office Ally: CAPMN |
| US Mail Submission | |
|---|---|
Mailing Address |
Conifer Health Solutions P.O. Box 261040 Encino, Ca 91426 |
Authorization Requests
For authorization requests submitted on or after January 1, 2024, please use the Conifer CapConnect provider portal, or continue to fax MDX Hawaii Prior Authorization and Specialty Referral Request Forms to (808)532-6999. For instructions on how to register for the provider portal see below.
As of 3/1/2024, MDX HI will no longer accept electronic claims for DOS 2023 and prior. Claims for 2023 and prior need to be submitted via paper to:
MDX Hawaii
Pacific Guardian Center- Makai Tower
733 Bishop Street
Suite 3000
Honolulu, HI 96813-4016
Starting on January 1, 2024, specialty drug authorization approvals will be for a period of 3 months, and quantity may not be specified on notification.
*Note: Conifer will be honoring the 2023 MDX Prior Authorization List (PAL) requirements until a 2024 PAL becomes available. More information will be provided in the upcoming months on Cap Connect.
If you have questions, please contact Conifer Customer Service: 1-800-851-7110
CapConnect Provider Portal
Getting started with the CapConnect provider portal, you can:
View membership roster
View claims status for dates of service on or after January 1, 2024
Submit authorizations for dates of service on or after January 1, 2024
Receive important MDX Hawaii and Conifer announcements
Conifer will activate designated usernames and initial passwords.
A powerpoint (attached below) and recorded training will be available on the Cap Connect provider portal.
Video Tutorial on Cap Connect
First, after Log In and at Home Page – Click on User Documentation –
Secondly, select Video Tutorial from top section titled "Main Documentation" on page 2 of opened document
