For your convenience, Partners for Quality Health (PQH) will submit CPC+ applications on behalf of PMAG physicians.
Please follow the steps below to complete your CPC+ application.
If you have any questions, please contact PQH at 808-942-1852.
You will need to gather some information to complete the CPC+ application.
Click here to download the Application Checklist and fill in the required information.
For assistance in completing the application checklist, contact PQH at 808-942-1852 or email Alyssa Castillo, Project and Marketing Manager, at acastillo@pqhhawaii.com.
You will need to submit a letter of support with your CPC+application. Click below to download the template:
You must fill in the date, physician name and signature.
Submit the following documents to PQH via email or fax:
Email both documents to Alyssa Castillo, Project and Marketing Manager, at acastillo@pqhhawaii.com or fax to 808-943-8732.
Please note: The CMS deadline for submitting applications is September 15, 2016. Please be sure to submit your documents to PQH by Friday, September 2nd so our team has adequate time to complete your online application.
For your convenience, PQH will submit your CPC+ application on your behalf. After your application has been submitted, you will receive a confirmation of submission.
PQH will send you a copy of your completed application for your records.