This window allows you to add, view and remove authorization requests from a Medicaid Provider for a specific business. In addition, the authorization process is supported by E-mail Notifications.
If a provider is not eligible to register in MEDI (e.g. it has no authorized applications), you cannot request authorization from it. Application authorization for providers is based on its provider type. Review Provider Application Access in the Appendix to determine whether the provider's type is eligible to register in the MEDI System.
If you select an application for which the provider does not have authorized access, you will receive an error message, and you will have to select another application. Review Provider Application Access in the Appendix for the applications available to each provider type.
Requesting authorization from a provider that the business has already requested authorization from is considered a duplicate request, and will be rejected no matter what status the request is in.
You can remove an authorization request from any provider, regardless of its present status. Once an authorization request is removed, it will no longer display on this page. If necessary, you can re-request authorization from the same provider after the authorization has been removed.
You must enter all required fields. The provider name and provider number must match HFS's Provider DB entry exactly.
If a provider is not registered, a message "Provider Not Registered" will display in the Provider Name field.
Warning: If you fail to correctly enter the provider name and provider number 5 times, your account will be locked, and you will be forwarded to the MEDI Account Locked page. You will have to contact Network Services to get your account unlocked. Review HFS's Contact Information for more information.
Review the Requesting Provider Authorization Overview for more information.
Field Name |
Definition |
Validation Rules |
Field Type |
|
Name |
the registered name of the business being displayed |
N/A |
Display Only |
|
Business Type |
the business category of the business being displayed |
N/A |
Display Only |
|
HFS ID Number |
the HFS identification number of the business being displayed |
N/A |
Display Only |
|
Tax ID Number |
the tax identification number of the business being displayed |
N/A |
Display Only |
|
Provider Name |
the name of the provider from which you are requesting authorization |
Required if provider number is entered. Must match the entry on the Provider DB exactly.
|
Text Box |
|
Provider Number |
the HFS identification number of the provider from which you are requesting authorization |
Required if provider name is entered. Must correspond to the entry in the provider name field. Must match the entry on the Provider DB exactly. Must be numeric. Must be between 9 and 12-digits in length, inclusive. |
Text Box |
|
Application |
the application for which you are requesting authorization |
Required if provider name or provider number are entered. |
Dropdown Box |
|
Claim Preparer Question |
indicates whether your organization is the claim preparer for the provider from which you are requesting authorization |
Required. You must answer this question in order to request authorization from the provider. |
Dropdown Box |
|
Remove |
checkbox for removing previous provider authorization requests |
Not required. If checked, the provider authorization request will be removed, regardless of the authorization status. |
|
|
Provider Name |
the provider's name from a previous request |
N/A |
Display Only |
|
Provider Number |
the provider number from a previous authorization request |
N/A |
Display Only |
|
Application
|
the application for which the authorization was requested |
N/A |
Display Only
|
|
Status |
status of the present authorization request |
N/A |
Display Only
|
|
Current Authorized Transactions |
the transactions that are currently authorized by this provider and the date it was authorized |
N/A |
Display Only |