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Provider Enrollment: Status

You can view the status of your enrollment application by providing your tracking and tax ID number. You can only make changes to the enrollment application if you have received a request for missing or incomplete enrollment information and edits are allowed.

Verify Enrollment Application Status

1. Enter your assigned Tracking Number.
2. Enter your Tax ID number.
3. Click Search. The Provider Enrollment - Summary panel appears below the Provider Enrollment - Status panel.

Click Cancel to cancel viewing the provider enrollment application status.

Revise Enrollment Application

If the enrollment has been returned to you for correction, a link will display to allow you to retrieve your application to make corrections.

1. Click Revise Enrollment Application if edits are allowed to the enrollment application.
   The Provider Enrollment: Revise Enrollment page appears.
   Note: If edits are not allowed, the link will not be displayed.
2. Enter your password and click Submit. The Provider Enrollment: Welcome page appears.

Click Cancel to cancel revising the enrollment application.

Provider Enrollment: Grievance

If the enrollment has been rejected, a link will display to allow you to submit a grievance request.  If you disagree with your enrollment status and/or information displayed, you can submit a grievance for review.

Grievance

1. Select one or more reasons for the grievance.
2. Enter any additional comments you may have.  Only the first 500 characters will be captured in the additional comments area.
3. Click Submit to return to the Provider Enrollment landing page.

Click Cancel to cancel the request.

Provider Revalidation: Status

The status of the revalidation application can be viewed by providing the Tracking Number. Changes are only able to be made to the application if a request for missing or incomplete information has been received.

Verify Revalidation Application Status

1. Enter the assigned Tracking Number.
2. Click Search. The Provider Revalidation - Summary panel appears below the Provider Revalidation - Status panel.

Click Cancel to cancel viewing the provider revalidation application status.

Revise Revalidation Application

If the revalidation has been returned for correction, a link will display to allow access to retrieve the application to make corrections.

1. Click Revise Revalidation Application if edits are allowed to the application.
   Note: If edits are not allowed, the link will not be displayed.
2. The Revalidation Application Welcome page appears.

Click Cancel to cancel revising the application.

Browser Hints - FireFox

1. Backspace key not working - use the short-cut menu (right mouse click) and select CUT to remove text.
2. Unable to modify existing text - use the short-cut menu (right mouse click) and select CUT to remove text.  Once text has been removed, you can replace it with the new value.