Welcome to the Online Trading Partner Enrollment Process

This online series will help you complete your Trading Partner Profile (TPP) and walk you through the enrollment process. Select the Continue button below when you are ready to move to the next page. You may also go back to previously viewed pages by selecting them from the page listings in the navigational menu to your left.

• This online form is intended for providers, clearinghouses, billing services, and software companies seeking to become Trading Partners. If you have previously received a Trading Partner ID and want to update your TPP, log on to your secure portal account.
• Personally identifiable information about providers is used for purposes directly related to health care program administration, such as determining the certification of providers or processing provider claims for reimbursement. Failure to supply the information requested may result in denial of payment for the services.
• Trading Partners are required to complete a Trading Partner Profile containing specific transaction and contact information as the first step in the Electronic Data Interchange (EDI) enrollment process. The EDI Department must receive and process the profile request before Trading Partners may begin testing.
• Only one TPP needs to be completed for each Trading Partner, even if the Trading Partner represents multiple providers. Billing providers that have multiple billing provider numbers, or billing services and clearinghouses that exchange the electronic transactions on behalf of providers need only complete one profile form. Accurate and timely completion of the profile form will prevent delays in testing and approval for production processing.

Please click the "continue" button to start the enrollment application.