Find forms that you may need to fill out and return to AlohaCare.
- AC Online Registration: Sign up to access member eligibility, claim billing and prior authorization information as well as electronic submission of referrals, prior authorization and notifications.
- Electronic Funds Transfer (EFT): Complete this form to receive direct deposit payments from AlohaCare for services billed provided to AlohaCare members. A copy of a voided check, current PVL and this form may be submitted to AlohaCare's Provider Relations Department via USPS or may be faxed to 973-0811.
- Drug Coverage Request: Request coverage for drugs that are not included on our formulary or require prior authorization.