Billing Provider Enrollment Process

Sole proprietorship location with only one practitioner providing service

Enrolling a group location

Enrolling a facility location

Separate application for each service location

Changing ownership (including mergers and acquisitions)

Group Member Enrollment Process

Individual practitioners rendering services as part of a group

Practice has 2 or more practitioners practicing under the same tax identification number (TIN)

Practice has an IHCP group provider number or is submitting a Group Member enrollment application along with a Billing Provider Enrollment application for a group provider number

The practitioner being enrolled as a member of your group has never previously enrolled in the IHCP.