Enter your assigned Tracking Number, Tax ID and password in order to:
- Continue an existing application has been saved but not yet been submitted
- Make corrections to an application that has been RTPd
- Upload attachments for an application that has previously been submitted
For further questions, please contact Provider enrollment at 1-800-457-4584.
Once an application has been completed, SUBMITTED
, and had all required attachments uploaded, you may not use this method to resume or view your application. To check on the status of your submitted application, please use the Enrollment Status page