Provider Enrollment   Skip portlet
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Become a Billing Provider
If you would like to become a Billing Provider for New Hampshire Medicaid, please complete the appropriate online application. If you are a billing group or individual applying with a Federal Employer Identification Number (FEIN), please select the Group Provider Enrollment link below.

If you are an Individual billing provider that does not have an FEIN and would be applying with your Social Security Number (SSN), please select the Individual Billing Provider Enrollment link below.

If you have questions, please contact Provider Enrollment at (603) 223-4774 or (866) 291-1674, Monday through Friday, 8 am - 5 pm EST.
Become a Non-Billing Provider
If you would like to become a Non-Billing Provider for New Hampshire Medicaid, please complete the appropriate online application.

Non-Billing Individual Rendering Providers are providers who, through an affiliation with a billing provider, render services for New Hampshire Medicaid members. Please select the Non-Billing Rendering Provider Enrollment link below.

Non-Billing Individual Ordering/Referring/Prescribing (ORP) Providers are providers who enroll for the sole purpose of ordering, referring or prescribing supplies, services and/or pharmaceuticals for New Hampshire Medicaid members. Please select the Non-Billing ORP Provider Enrollment link below.

If you have questions, please contact Provider Enrollment at (603) 223-4774 or (866) 291-1674, Monday through Friday, 8 am - 5 pm EST.
Become a Trading Partner
If you would like to become a Trading Partner (EDI) to electronically exchange data with New Hampshire Medicaid, please complete the online Trading Partner application. Select the Trading Partner Enrollment link below.

If you have questions, please contact Provider Enrollment at (603) 223-4774 or (866) 291-1674, Monday through Friday, 8 am - 5 pm EST.
Application Status
To check the status of your New Hampshire Title XIX Program Provider or Trading Partner Application, use your Application Tracking # and click the SUBMIT button.
  
Recall Provider Application
To recall an application that you have partially completed, enter your Application Tracking Number, and SSN / FEIN and click the SUBMIT button.
Note: Saved applications can be recalled and resumed prior to submission for (12)months. All previously entered data should be reviewed and confirmed prior to submission.




Recall Trading Partner Application
To recall an application that you have partially completed, enter your Application Tracking Number and SSN / FEIN and click the SUBMIT button.