Are you sure you want to logout?
If you navigate away from this page, you will lose unsaved data. Are you sure you want to logout?
Sunday 10/22/2017 05:46 AM
Provider Enrollment Application
Initiate a new provider enrollment application (includes optional Electronic Fund Transfer (EFT) enrollment).
Resume an existing enrollment application that has not been submitted, or correct a submitted application that has been returned for needed provider corrections (RTPd).
Check the current status of an enrollment application.
Provider Enrollment Type and Specialty Matrix
© 2017 Indiana Medicaid | R4.2 |
Medicaid Provider Home Page