Provider Enrollment: Welcome
Provider Enrollment allows providers and authorized delegates to enter all pertinent enrollment information via a wizard. The enrollment wizard captures key provider data such as contact information, provider type, specialties, and provider demographics such as names, identifiers, locations, and languages.
The Provider Enrollment wizard allows you to navigate through each page of enrollment, from the contact information in the first page, to the final print preview of the summary information page . You can save an electronic copy for future reference. A tracking number is also provided so that providers can check the status of their enrollment request.
Navigation
A table of contents appears, on the left hand side, at all times during the enrollment process to show your current location in the enrollment process.
As you navigate through each page of the enrollment wizard, all previous pages in the wizard are displayed in the table of contents as a link. You can navigate back to that link to apply changes, if needed. You cannot navigate forward within the table of contents, beyond the current page in which you are working. You can navigate back to a previous page, apply updates, and/or return to the current page by using the table of contents. You can enter a partial application and resume the enrollment process at a later time by clicking Finish Later on any page once you have entered the required information on the Request Information page. You can cancel the provider enrollment process at any time, however, data that has been entered will be lost and you will be navigated out of the provider enrollment application.
Welcome
Provider Revalidation: Welcome
Provider Revalidation allows providers and authorized delegates to validate all existing enrollment information via a wizard.
The wizard allows you to navigate through each page of the revalidation process, and review the information displayed. Each page will display existing information in the system or will return blank fields: some fields are displayed as static and unable to be changed, while others must be completed. An electronic copy of the information can be saved for future reference. A tracking number is also provided so that providers can check the status of the revalidation request.
Navigation
A table of contents appears, on the left hand side, at all times during the process to show your current location.
Pages must be completed in the order listed in the table of contents and cannot be skipped. All previous pages completed in the wizard are displayed in the table of contents as a link during the revalidation process and are accessible using the link to apply changes, if needed. A previous page can be selected, updates applied, and returned to the current page by using the table of contents.
A partially completed revalidation application may be saved to resume the revalidation process at a later time by clicking Finish Later on any page once the required information has been entered on the Request Information page. The Cancel option will cancel the revalidation application and all data entered, including attachments, will be lost.
Click Continue or press the Enter key to begin the revalidation process.