Next steps for new Medicaid providers

What happens after I enroll?

Once enrolled, documents are sent to the mailing address provided on your application. Documents include:

• A welcome letter.
• A unique ProviderOne ID assigned to you or your business.
• Billing providers only:
  • A Provider Supplemental Information Request form*. The request form must be filled out and returned via email or fax (on the form) in order for your business to gain access to ProviderOne.

* Once approved, ProviderOne Security emails you a temporary password. This gives you access to the ProviderOne billing and claims system as a designated ProviderOne system administrator. Your only function as a ProviderOne system administrator is to set up system users. Only users are able to submit claims in ProviderOne. Please see the step by step instructions for setting up a user in ProviderOne.

How do I request prior authorization (PA) for services?

Some services require prior authorization (PA) before you can provide the service. Learn how to submit a PA using the step-by-step instructions on our Prior authorization (PA) page.

How do I submit a claim?

Billing providers submit all claims through ProviderOne. Use the following resources to learn how to use ProviderOne to submit a claim:

• ProviderOne Billing and Resource Guide (general user guide for submitting claims in ProviderOne)
• Provider rates and billing guides (service billing instructions and fee schedules)

How do I get paid?

All claims for eligible services are submitted and paid through ProviderOne.

Where can I get help with my login?

If you need help with your login, password or administering your ProviderOne account, contact ProviderOne Security for support.

Is there training?

We provide online learning materials and webinars to help you get up-to-speed using ProviderOne.

• ProviderOne user manuals (step-by-step instructions for using ProviderOne)
• ProviderOne social service tutorials (step-by-step instructions for social service providers)
• Fact sheets (quick reference for common questions using ProviderOne)
• Webinars (past webinar presentations)