This window allows you to select the type of registration you want to perform, either Business or Employee Registration.
You must have accepted the User Security Agreement to get to this page. After accepting the User Security Agreement, you can access this page at any time.
Review the Registration Overview for more information.
Field Name |
Definition |
Validation Rules |
Field Type |
MEDICAID PROVIDER |
hyperlink to Provider Registration page |
N/A |
|
HERE |
hyperlink to the Request a Provider Information Sheet page |
N/A |
|
PAYEE |
hyperlink to Payee Registration page |
Only available from 8am to 5pm, Monday thru Friday. |
|
PAYOR |
hyperlink to Payor Registration page |
N/A |
|
request a Payor Information Sheet |
hyperlink to Request a Payor Information Sheet page |
N/A |
|
OTHER BUSINESS |
hyperlink to Other Business Registration page |
N/A |
|
EMPLOYEE REGISTRATION |
hyperlink to Employee Registration page |
N/A |