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What services are included in our Provider Portal?

The Provider Portal allows facilities, professional providers and billing services to perform the following:

  • Access claim information
  • Authorization inquires
  • Eligibility inquiries
  • Enroll in EFT/ERA Services

Portal Services Signup:

What type of provider are you?

Select your provider type below to view detailed instructions on gaining access to Provider Portal Services.

Professional Providers:

  1. Download the Professional Provider Portal Services Application and Use Agreement (PDF)
    • Read the Use and Protection Agreement completely.
    • For convenience and accurate processing, we recommend completing the form by typing answers in the form fields prior to printing.
    • Print and sign the completed Application.
    • Please Note: The Application cannot be processed without a signed Use and Protection Agreement.

  2. Fax or Mail signed forms to the address or fax number listed on the forms.

  3. We will contact you with User ID and password information.

Facility Providers

  1. Download the Facility Provider Portal Services Application and Use Agreement (PDF)
    • Read the Use and Protection Agreement completely.
    • For convenience and accurate processing, we recommend completing the form by typing answers in the form fields prior to printing.
    • Print and sign the completed Application.
    • Please Note: The Application cannot be processed without a signed Use and Protection Agreement.

  2. Fax or Mail signed forms to the address or fax number listed on the forms.

  3. We will contact you with User ID and password information.

Billing Services

  1. Download the Billing Service Provider Portal Services Application, Use Agreement and Authorization for Representative Access (PDF)
    • Read the Use and Protection Agreement completely.
    • For convenience and accurate processing, we recommend completing the form by typing answers in the form fields prior to printing.
    • Print and sign the completed Provider Portal Services Application and Authorization for Representative Access form.
    • An authorized representative of the provider must complete the accompanying Authorization for Representative Access form, which grants the billing service authority to access the Provider Portal.
    • Please Note: The Application cannot be processed without a signed Use and Protection Agreement and a completed Authorization for Representative Access form.

  2. Fax or Mail signed forms to the address or fax number listed on the forms.

  3. We will contact you with User ID and password information.

Need Help?

If you're having trouble accessing or completing the Provider Portal Services application, or need help signing in, please call our Provider Portal Support at (616) 949-2410.