Provider Reset Page

Request user ID/Reset Password

Field	Description
Medicaid Provider ID	The medicaid provider's Medicaid ID.
	User selects either if they forgot User ID or forgot Password.
Reset Via	User selects either to reset via email or security questions.

 

Initiate Retrieve User ID via Email

Field	Description
Forgot User ID	User ID that the medicaid provider uses.
Reset via: Email	The option to use email to retrieve the providers User ID.
E-mail Address	The medicaid provider's email address used during enrollment.

 

Initiate Retrieve User ID via Security Questions

Field	Description
Forgot User ID	User ID that the medicaid provider uses.
Security Question	The option to use security questions to retrieve User ID.
Security Answer 1	Answer to the first security question.
Security Answer 2	Answer to the second security question.
Security Answer 3	Answer to the third security question.
Security Answer 4	Answer to the fourth security question.

 

Initiate Reset Password via Email

Field	Description
Forgot Password	The Password the provider wants to reset.
Reset via: Email	The option to use email to reset the providers Password.
User ID	User ID that the medicaid provider uses.
E-mail Address	The medicaid provider's email address used during enrollment.

 

Initiate Reset Password via Security question

Field	Description
Forgot Password	The Password the provider wants to reset.
Security Question	The option to use security questions to reset Password.
User ID	User ID that the medicaid provider uses.
Security Answer 1	Answer to the first security question.
Security Answer 2	Answer to the second security question.
Security Answer 3	Answer to the third security question.
Security Answer 4	Answer to the fourth security question.

 

Buttons	Description
Submit	To submit the selection.
Reset	To clear the selection and re-select.
Cancel	To cancel the Password reset