Provider Enrollment

Physician — Individual Billing Medicaid

If you do/will provide Medical Services and the services you provide will be billed to Medicaid by you or by a group practice, Click Here for the Enrollment Form and instructions.

Physician — Non Billing - Ordering/Prescribing/Referring/Attending (OPRA) or Managed Care Network Provider

If you will NOT be billing fee-for service (FFS) Medicaid, click here for the Enrollment Form and instructions.

Physician — Change From Non Billing (OPRA or Managed Care Network Provider) To Billing Provider

If you are already enrolled as a non-billing OPRA or managed care network provider and wish to bill fee-for-service Medicaid, click here for the Enrollment Form and instructions.