Provider Enrollment

Provider Participation

To participate in the RI Medicaid, providers must be located and performing services in Rhode Island or in a border community PDF. Consideration will be given to out-of-state providers if the covered service is not available in Rhode Island, the recipient is currently residing in another state or if the covered service was performed as an emergency service while the recipient was traveling through another state.

Instructions

To become a Medicaid Provider, please select from the links below. Please be sure to complete all information on the application prior to submitting.

For New Providers

Medicaid Provider Application - Individuals  
Medicaid Provider Application - Groups  

Adding a Provider, RIte Share, and LEA Providers

New Provider Joining an Existing Group
RIteShare Providers 
Local Education Agency (LEA) Providers


Enrolling as a Trading Partner

Once you are enrolled in RI Medicaid you will need to create a Trading Partner ID to access eligibility, claim status and remittance advice.  Applicants may access the electronic enrollment process by visiting the RI Healthcare Portal.

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.

Additional Forms

Authorization for Direct Deposit (Mandatory)
Provider Change of Information Form PDF
Non-Emergency Medical Transportation New Provider Questionnaire 

Send all forms to:

HP Enterprise Services/Provider Enrollment
P.O. Box 2010
Warwick, Rhode Island 02887-2010

Need help with the application process?   Please call: Dianne Folco (401) 784-3801

LINKS

Are you using Electronic Billing?
Billing software is available at no cost to RI Medicaid Providers. Download a copy of our proprietary software Provider Electronic Solutions (PES) Software. We provide training and support to get you started.

Want to check your Claims or Prior Authorization status online?
Call us today on how to get started using EOHHS’ Healthcare Portal. Please call an EDI Coordinator at (401) 784-8014 for more information.

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