Select one of the following options that best describes your role.
An individual, state or local agency, corporate, or business entity that is enrolled in the Healthcare program as a provider of services.
An individual Designated by the Provider for the sole purpose of performing clerical functions and is responsible for ensuring patient privacy information accessed via this website is to be used only for legitimate business reasons.
Note that although there can only be one provider administrator (who registered as a provider), the administrator can register many delegates to utilize the website from different physical locations. These delegates must be identified and registered by the provider administrator.
An out-of-network business entity that is enrolled in the Healthcare program as a provider of services.