Forms & Applications

You will find Medicaid Provider forms and applications below. There is also a reference for all the forms and applications in alphabetical order as well.

Forms and Applications A-Z
All documents are in pdf format PDF

Medicaid

Provider Enrollment Application and Related Forms

Business Process Forms

Prior Authorization Forms

 

Rhode Island Medicaid is implementing an electronic process for enrolling and updating Trading Partners.  Due to this transition, we will be unable to accept Trading Partner enrollment applications or add/change forms after Tuesday, September 9, 2014. Forms received after this date will be returned.

Beginning Wednesday, September 17, applicants may access the electronic enrollment process by visiting http://www.eohhs.ri.gov/ProvidersPartners/HealthcarePortal.aspx.

All existing Trading Partners are required to register in the Healthcare Portal.  Please refer to the current issue of the Provider Update.  Additional resources are found on the Healthcare Portal page. 

PDF All PDFs require the free Adobe Reader.
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