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The Registration page features a How-To-Register Video as well as an in depth FAQ.
To Register do the following steps:
1. Click on ""New Provider Registration". The first part of the registration page will appear.
2. Select either "Medicaid" or "Medicare"
3. If you chose Medicaid, select State
4. Select role type: Individual Physician or Facility or Group
(click on radio buttons to see full descriptions)
If you are an Individual Physician, a Provider ID is required.
Facility or Group role type is especially for Hospital,Clinic, IPA/Group, or Agency staff.
Registering as Facility/Group allows the user to submit claims in addition to other functions.
If you do not know your Provider ID, contact you Provider Services Representative.
5. Click "Next" and the second part of registration will appear. The following fields for information are required fields.
6. Enter first name then last name
7. Enter e-mail address then enter again to confirm e-mail
8. Create a unique user ID using 8-15 characters long with no spaces and using the following characters only: A-Z, a-z, 0-9, ".","_"
9. Create a unique password using 8-12 characters long with no spaces and using the following characters only:
A-Z, a-z, 0-9, : ~! @ # $ % ^ & * _ - + = ` | \ ( ) { } [ ] : ; " ' , . ?. (cannot contain partial User ID, First Name or Last Name)
10. Select 3 security question and enter answer in corresponding field (all 3 questions must be different from each other)
11. Accept "Provider Online User Agreement" by clicking on check box
12. Enter the Code in the textbox as shown in the image.
13. When all fields are filled, click "Register"
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