Provider Portal Registration Form

Thank you for your interest in coming on board with Provider Portal!

Provider Portal is a quick and easy online tool that allows access to claim inquiry, Provider Dispute Resolution claims inquiry and Referral inquiry and submission.

To begin, please answer the following questions. Which of the following best describes your role?

I am in a provider’s office, clinic, ancillary facility, or a hospital.

I am an external biller, located outside of a provider’s office.