Embed Size (px)
Citation preview
Maryland Department of Health Electronic Provider Revalidation Enrollment Portal (ePREP) Guide
As part of the Accountable Care Act, all ordering, referring and/or prescribing providers are required to enroll with Medicaid. This includes residents who heretofore may have not previously enrolled. Failure to enroll will cause prescriptions for Medicaid patients will be denied at the pharmacy. If you have not previously registered with Medicaid, either on paper or online, please follow the instructions below and enroll in the online system.
If you have a Medicaid number, please provide that number to your residency director. For those enrolling for the first time, please send the number to your residency director when you receive it.
Access the ePREP portal at: https://eprep.health.maryland.gov/sso/login.do? Click Sign Up.
Complete the required information and click Continue.
1 | P a g e
Complete the password recovery information and click Sign Up.
2 | P a g e
You will receive an activation email from [email protected]. Click on the ePREP Portal Activation hyperlink to complete your applications.
Enter your password and click Submit.
Type in your NPI ID and click Verify.
3 | P a g e
Type in your name as the Business Profile Name and click Create Business Profile.
Click on My Applications.
4 | P a g e
Click on New Application.
5 | P a g e
Click the option, I’m new to Maryland Medicaid, and I want to create a new application. Then select the option, I’m an Individual health care practitioner. Then click Continue.
Select the option, I’m an Ordering/Referring/Prescribing (ORP) provider. Then click Continue.
6 | P a g e
Enter your NPI number again and click Verify.
Verify your information is correct and click Yes and then click Continue.
7 | P a g e
Select Prescribing Provider as the provider type and click Continue.
Complete the required information and then click Continue.
8 | P a g e
Complete the Correspondence Address information and click Continue.
Complete the Identity information by entering your Social Security number and selecting Yes or No on the Alias question, then click Continue.
9 | P a g e
Review the summary of information, make any necessary edits, and then click Continue.
Click the box to add yourself as the contact person, then click Continue.
10 | P a g e
Verify the contact person information, then click Continue.
When you get to the Invidivual Licenses & Certifications screen, if you do not have a medical license, Medicaid has advised to upload you program certificate. Click Add.
11 | P a g e
Complete the required information. Again, upload a copy of your residencey program certificate in lieu of a medical license.
Indicate if you have a DEA Certificate by selecting Yes or No. If Yes, you will be prompted to upload a copy of your DEA Certificate.
12 | P a g e
On the NPI screen, click N/A under Associated Specialty Codes. In the pop-up box, Please Explain, type in Prescriber only, then click Continue.
Answer each question and click Continue.
13 | P a g e
Continue answering questions on the following pages and click Continue to move through each page.
Click the hyperlink to read the Maryland Medicaid Provider Agreement. Then click the X to close and click the box to acknowledge and check all the boxes listed below.
14 | P a g e
Click the X to certify you have read the agreement.
Then check all the boxes to complete the Electronic Signature.
Continue with the e-signature page.
15 | P a g e
On the final page, click Submit Application to finish.
16 | P a g e
