Comprehensive Primary Care Plus (CPC+)

For your convenience, Partners for Quality Health (PQH) will submit CPC+ applications on behalf of PMAG physicians.

Submit completed documents to PQH by email (acastillo@pqhhawaii.com) or fax (808-943-8732).

Please follow the steps below to complete your CPC+ application.
If you have any questions, please contact PQH at 808-942-1852.

STEP 1: Complete Application Checklist

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.

STEP 2: Sign Letters of Support *UPDATED 09.12.16*

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.

STEP 3: Submit Documents to PQH by September 2, 2016

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.

STEP 4: Receive Confirmation of Submission

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.


Documents

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