1. STEP 1

   Navigate to your enrollment page by clicking on the appropriate provider link on the Provider Index page

2. STEP 2

   Click on your Provider Type and Complete the Enrollment Form

   • The Category of Service is listed in "Additional Instructions for the Enrollment Form" drop down menu OR in the Quick Reference Box in the upper right hand corner of the page.
   • Check the REVALIDATION BOX
   • Provider Number is in the Letter that was Sent
   • Make sure you sign the form
   
   
3. STEP 3

   Complete any additional requirements needed as specified in the "Requirements & Additional Forms" drop down menu.

   • NOTE: ETIN and EFT are NOT required for revalidation
   • Make sure to include the application fee if one is required
4. STEP 4

   
   MAIL TO:

   eMedNY
   PO Box 4603
   Rensselaer, NY 12144

   For Expedited/Proiorty Mailing, please click here

   Make Sure You Keep Your Addresses Up-To-Date

   click here to change your address

After submission of the revalidation application and additional required documents, continue to bill as normal. You will not receive a written notice that the revalidation packet was received.

1. Pre-screening by eMedNY:
   • If errors on the application form or the packet is incomplete (missing a required document): The entire revalidation packet will be returned by mail, including a checklist which details what is required and missing. Resubmit the completed revalidation, including all requested information, or documents to eMedNY as soon as possible for re-screening.
   • If no errors are detected: The revalidation application will be scanned and entered into the eMedNY system. This may take 2-3 weeks from receipt. You may contact the eMedNY Call Center to obtain and document the Enrollment Tracking Number (ETN) of the revalidation.
2. Review by the Bureau of Provider Enrollment:

   eMedNY does not send any correspondence once a revalidation has been queued for review by the Bureau. There are no timeframes associated with the processing of revalidation applications. Continue to bill NY Medicaid as normal.

   If reviewers require additional information for the processing of your Revalidation, the Bureau of Provider Enrollment will correspond with you directly by mail or by the applicant's e-mail address found on the application form. The Bureau of Provider Enrollment cannot e-mail the corporate email address.

   When the submitted revalidation is approved by the Bureau of Provider Enrollment, a "Successful Revalidation" letter will be sent to the address on the application.

   The next time you must revalidate is five years from the date on this letter.