Prior Authorization in Hawaii
Soft Home Global provides authorizations submitted ahead of the date of service and chased to a decision for Hawaii practices and billing companies at $2,050 per seat per month. Full time, worked during Hawaii business hours, inside your own system.
What is specific to Hawaii
Hawaii delivers almost all Medicaid through QUEST Integration health plans, and the commercial market is concentrated partly because the 1974 Prepaid Health Care Act obliges employers to cover staff working at least twenty hours weekly.
Hawaii’s Medicaid programme is Med-QUEST (QUEST Integration). Practices with a meaningful Med-QUEST (QUEST Integration) mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
What a prior authorization seat does in Hawaii
Submitted before the date of service and chased through the payer's decision window.
An authorisation found after the visit is a write-off, not a denial to appeal. In Hawaii the work is submitting ahead of scheduling and chasing the decision, against a payment clock that starts only once a clean claim lands.
- Authorizations submitted ahead of scheduling, not after
- Status chased rather than waited on
- Peer-to-peer reviews scheduled when required
- Clinical documentation gathered before submission
- Expiring authorizations flagged before they lapse
- Worked during Hawaii business hours, not queued overnight
For the statute behind all of this — Hawaii’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Hawaii billing page.
Working Hawaii hours
Hawaii runs on Hawaii-Aleutian time, 15 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 12am to 8am. Hawaii does not observe daylight saving, so that overlap is the same every week of the year. For most of the country it moves twice, and the practices that notice are the ones whose payer calls sit near the edge of the window.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Hawaii hours and nobody else’s.
What it costs in Hawaii
$2,050
Per seat, per month, in US dollars — $24,600 a year for one full-time person, forty hours a week, on Hawaii hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Hawaii run $1,600 to $2,700; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Hawaii
About a week from a signed agreement to a person working your queue, and that week of training on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.
Questions
Do you work with Hawaii practices?
Yes. Hawaii accounts are worked during Hawaii office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Hawaii?
Hawaii delivers almost all Medicaid through QUEST Integration health plans, and the commercial market is concentrated partly because the 1974 Prepaid Health Care Act obliges employers to cover staff working at least twenty hours weekly.
When does a Hawaii payer have to pay a clean claim?
15 calendar days for electronically filed clean claims; 30 calendar days for claims filed in writing (fastest electronic deadline of any state reviewed here) A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does prior authorization cost in Hawaii?
$2,050 per seat per month — $24,600 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Hawaii queue?
Hawaii is on Hawaii-Aleutian time, 15 hours behind Rawalpindi. The shift here runs 12am to 8am so your seat is at a desk for your full working day. Because Hawaii does not observe daylight saving, that window is identical every week of the year.
Do you handle Med-QUEST (QUEST Integration) as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. Med-QUEST (QUEST Integration) has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
Next step
One seat on your Hawaii work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com