Instructions for Step 3
Before beginning an application through the Online Provider Enrollment (OPE) tool, it is highly recommend to:
- Print the Enrollment checklist (from step 2).
- Download (and review) the this link will open the provider enrollment manual in a new window Provider Enrollment Manual.
After reviewing the training materials, click here to begin an application.
IMPORTANT: If choosing "Finish Later", it is important to keep track of the tracking number, password, and the TIN used. If the password is lost, the application will need to be started over.
Frequently Asked Questions (FAQs)
For the required documents, is it acceptable to provide a PSV (Primary Source Verification) or would it need to be the original copies? Example: Using DORA website to pull license and board examiners verification, using DEA Diversion to verify DEA, using Board Cert website for verification that currently boarded, using PECOS online system to obtain Medicare approval/active letter
Copies of documents are accepted.
Where should the required documents be sent?
All documents must be uploaded through the "attachments" section of the online application. Note: upload all documents with the submission of the application. The system will not hold documents when "Finish Later" is selected.
Do we need to supply a billing address if we do not submit our own billing?
Yes, the application requires a mailing address, a service address, and a billing address. This does not mean that billing will occur.
Do we need to enroll our locations and our practitioners, or just our locations?
What should I do if I lose my tracking number?
Call the Provider Services Call Center at 1-844-235-2387.
How can I reset my password?
The Provider Portal Enrollment Application password cannot be reset. If you forgot your password, you can still resume your application by choosing “Forgot Password” and then answering the security questions correctly. If you forgot your password and the answer to your security questions, you will need to begin a new application.
Is there someone I can talk to about my application?
The Provider Services Call Center (1-844-235-2387) is available to answer questions on applications.