Get Website Registration For Access To Secured Portal

Registering for access to the secured portal ensures you can manage claims and verify eligibility efficiently. This guide will help you understand the necessary steps for filling out the Website Registration for Access to Secured Portal online, ensuring a smooth registration process.

Follow the steps to complete your online registration.

1. Click ‘Get Form’ button to obtain the registration form and open it in your online editor.
2. Fill in the practice or facility name in the designated field.
3. Provide the complete address, including street, city, state, and zip code.
4. Enter the contact person's name who will handle inquiries.
5. Include the phone number and fax number for your practice.
6. Input the email address where the password will be sent.
7. Supply the tax identification number for your practice.
8. If applicable, enter the Practice/Facility Type II National Provider Identifier (NPI), or list the Type I NPI if you do not have Type II.
9. Once all information is completed, review the form for accuracy.
10. Submit the form online or, if preferred, print and fax it to the designated number for processing.
11. After submission, wait for the email containing your password. It is advisable to change this password following your first login.

Start your online registration now to gain access to valuable health plan resources.