About Provider Enrollment Pages
You use the following field descriptions pages to add or update an individual, group, or trading partner enrollment application.
Field Descriptions
Individual Billing Provider Enrollment (Identifying Information) Page
Individual Billing Provider Enrollment (Licensure/Certification) Page
Individual Billing Provider Enrollment (Provider Identifier Numbers) Page
Individual Billing Provider Enrollment (Service) Page
Individual Billing Provider Enrollment (Group Affiliation) Page
Individual Billing Provider Enrollment (Electronic Transaction Submission) Page
Individual Billing Provider Enrollment (Ownership) Page
Individual Billing Provider Enrollment (Exclusion/Sanction) Page
Individual Non-Billing Rendering Provider Enrollment (Identifying Information) Page
Individual Non-Billing Rendering Provider Enrollment (Licensure/Certification) Page
Individual Non-Billing Rendering Provider Enrollment (Provider Identifier Numbers) Page
Individual Non-Billing Rendering Provider Enrollment (Service) Page
Individual Non-Billing Rendering Provider Enrollment (Group Affiliation) Page
Individual Non-Billing Rendering Provider Enrollment (Exclusion/Sanction) Page
Individual Non-Billing ORP Provider Enrollment (Identifying Information) Page
Individual Non-Billing ORP Provider Enrollment (Licensure/Certification) Page
Individual Non-Billing ORP Provider Enrollment (Provider Identifier Numbers) Page
Individual Non-Billing ORP Provider Enrollment (Service) Page
Individual Non-Billing ORP Provider Enrollment (Exclusion/Sanction) Page
Group Provider Enrollment (Demographic) Page
Group Provider Enrollment (Licensure & Certification) Page
Group Provider Enrollment (Provider Identifier Numbers) Page
Group Provider Enrollment (Service) Page
Group Provider Enrollment (Group Affiliation) Page
Group Provider Enrollment (Electronic Transaction Submission) Page
Group Provider Enrollment (Ownership) Page
Group Provider Enrollment (Exclusions/Sanctions) Page
Individual or Group Provider Enrollment (Submit Application Step 1) Page
Individual or Group Provider Enrollment (Submit Application Step 2) Page
Individual or Group Provider Enrollment (Submit Complete) Page
Trading Partner Enrollment (Identifying Information) Page
Trading Partner Enrollment (Transactions) Page
Trading Partner Enrollment (Provider Affiliations) Page
Trading Partner Enrollment (Carrier Affiliations) Page
Trading Partner Enrollment (Submit Application Step 1) Page
Trading Partner Enrollment (Submit Application Step 2) Page
See Also