1     Obtain Portal Access

All NYS DOH Medicaid providers are required to have a NY.gov username in order to login to NYS Medicaid Provider Services Portal.

1. Click on the login link: https://my.ny.gov/LoginV4/login.xhtml
2. Click Create an Account.
3. Select Business.
4. Click on NYS Department of Health (NYSOH)
5. Enter data into the following fields:
   • First Name, Last Name
   • Email (use your business email)
   • Confirm email
   • Username
   • Check the Captcha box and verify pictures (if required)
6. Click Create Account.
7. Verify all information. Click Continue to proceed or Back to update.
8. Click Finish.
9. Go to your email account and find the message from "NY.govID@its.ny.gov."
10. Open the email and click on the link to activate the NY.gov account.
11. Click Continue.
12. Select questions and enter valid responses to all three secret questions.
13. Click Continue.
14. Enter a new password that meets the criteria.
15. Click Continue.
16. Close the browser window.

2     Start an Enrollment Application

Providers will enter basic information about themselves and/or their organization, including contact information and identifiers required to create an application.

The system will assign a unique Application ID (IMPORTANT, always write down this ID). With this ID providers can:

• track the status of an application, and
• return later to complete or update the application (if it has not yet been submitted).

3     Complete the Enrollment Application

Detailed information will be requested related to provider type, services offered, billing status, affiliations, and compliance with Medicaid program requirements.

• Each field is identified as mandatory or optional.
• Incomplete applications can be saved at any time and returned to later for modification or completion as long as the application status is "In Process."
• Providers can upload required documentation, such as licenses, certifications, or ownership disclosures.

* Applications started but not submitted within 20 days will be deleted. If deleted, you must begin the application process again.

Once all required information has been entered and documentation has been uploaded, the application should be:

• reviewed for accuracy, and
• submitted to the State for review.

After submission:

• the application status changes to "In Review," and
• changes can no longer be made unless you receive a request for updates or corrections.

4     Review of an Enrollment Application and Determination of Enrollment:

Once an application is submitted and under review

• all information will be verified for accuracy and completeness,
• eligibility and compliance with Medicaid program requirements will be confirmed, and
• notifications will be sent to the provider as applicable (e.g., rejected and returned application, request for additional information, documents or corrections), and**
• an application's progress can be monitored in the system using the Application ID.

** If you receive a notification, respond promptly to avoid delays in processing or withdrawal of the application (after 45 days). If withdrawn, you must begin the application process again.

When review of the application is complete,

• the application status is updated in the system and a notification is sent by e-mail;
• the system updates the provider’s status to "Active," (provider can begin participating in the NYS Medicaid program) or "Denied," as applicable; and
• the provider will receive a determination in writing that includes the effective date of enrollment if approved.