This window allows a provider administrator to grant/revoke/hold authorization for any business that has request authorization from the provider.
Changes to the status of an authorization request take effect immediately.
You may change any request for authorization to a different status.
Any authorization request that has been removed by the requesting business will not be displayed.
Warning: A business cannot work on behalf of the provider unless the authorization request is in ACTIVE status (e.g. it must be ACCEPTED).
You must be an active administrator for a business registered in the Medicaid Provider category in order to access this page.
For the Internet Electronic Claims (IEC) System, you must also authorize the specific transactions that the requesting business can access on behalf of the provider.
Review the Provider Business Authorization Overview for more information.
Field Name |
Definition |
Validation Rules |
Field Type |
|
Name |
the registered name of the provider business being displayed |
N/A |
Display Only |
|
HFS ID Number |
the HFS identification number of the provider business being displayed |
N/A |
Display Only |
|
Tax ID Number |
the tax identification number of the provider business being displayed |
N/A |
Display Only |
|
HFS ID Number |
the HFS ID number of the business requesting authorization |
N/A |
Display Only |
|
Business Name |
the name of the business requesting authorization
|
N/A |
Display Only |
|
Address |
the address of the business requesting authorization |
N/A |
Display Only |
|
Administrators |
the name of the administrator of the business requesting authorization |
N/A |
Display Only |
|
Contact Information |
the phone number and e-mail address of the administrator for the business requesting authorization |
N/A |
|
|
Accept |
Clicking the Accept radio button indicates you authorize the business to work on behalf of the provider. If the business' authorization is in Accept status, it is enabled to work on behalf of the provider. |
One of the two radio buttons must be selected. |
|
|
Reject |
Clicking the Reject radio button indicates you do not authorize the business to work on behalf of the provider. If the business' authorization is in Reject status, it is not enabled to work on behalf of the provider. |
One of the two radio buttons must be selected. |
|
|
Application Status |
the application for which the business is requesting authorization, its current status and the date of the current status |
N/A |
Display Only |
|
Current Authorized Transactions |
For the IEC System only. A list of the currently authorized transactions, and the date it was authorized. |
N/A |
Display Only |
|
Accept or Reject these Transactions |
For the IEC System only. Provides a list of the transactions that can be authorized. Currently authorized transactions are checked. |
If the authorization is in Accept status, at least one transaction must be checked. |
|
|
Check All |
For the IEC System only. A button that checks all the transactions for the current authorization. |
N/A |
|
|
Uncheck All |
For the IEC System only. A button that unchecks all the transactions for the current authorization. |
N/A |