Contact Us
|
FAQs
|
Login
Logout Confirmation
Are you sure you want to logout?
Logout Confirmation
If you navigate away from this page, you will lose unsaved data. Are you sure you want to logout?
Home
Home
>
Provider Enrollment
Wednesday 11/06/2024 04:22 AM
Provider Enrollment
Provider Enrollment Application
Initiate a new provider enrollment application (includes optional Electronic Fund Transfer (EFT) enrollment).
Resume Enrollment
Resume an existing application for the following reasons:
Application has been saved but not yet been submitted
Application has been RTPd for correction
Application attachments need to be added
Enrollment Status
Check the current status of an enrollment application.
Customer Links
W-9 Form
Provider Enrollment Type and Specialty Matrix
© 2024 Indiana Medicaid | R4.2 |
Privacy Policy
|
Medicaid Provider Home Page