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Provider Enrollment: Status

You can view the status of your enrollment application by providing your tracking and tax ID number. You can view and print the enrollment application cover sheet if it is available. You can also revise the enrollment application if edits are allowed. The enrollment status can be accessed from either the welcome or secure home pages.

Verify Enrollment Application Status

1. Enter your assigned tracking number.
2. Enter your tax ID or SSN.
3. Click Search. The Provider Enrollment - Summary panel appears below the Provider Enrollment - Status panel.
-- OR --
Click Cancel to cancel viewing the provider enrollment application status.

Provider Enrollment: Summary

If the enrollment status and the reason and notes are displayed in this panel. One or more links may display depending on the status of your enrollment. If supported, a cover sheet link, a revise enrollment link and/or a grievance link may display.

View and Print the Enrollment Application Cover Sheet

1. Click click here. The Provider Enrollment: Cover Sheet page appears in a separate window.
   Note: If the cover sheet is not available, the link will not be displayed.
2. Click Print. The Print dialog box appears.
3. Select the desired printer, print options, and click Print. The Provider Enrollment: Cover Sheet prints at the selected printer.
4. Click Close to close the Provider Enrollment: Cover Sheet page.

Provider Letters

1. To view the letters sent to the provider regarding this application, enter the Password used for the application and click Submit.