User Account Setup

User Account Setup

Set Up Your User Account

Please enter the information below to set up your provider user account by completing Sections 1 and 2. To associate to a specific provider agency, choose the appropriate option and then complete Section 3. When you have completed the appropriate sections, click the Submit button.

Section 1 - User Information

First Name :

Middle Initial :

Last Name :

Date of Birth :

Ex: mm/dd/yyyy

Email Address: :

Address :

City :

State :

Zip Code :

Phone Number :

I understand that state and federal laws require that information regarding persons applying for Medicaid Presumptive Eligibility or ABE programs be safeguarded from unauthorized use or disclosure.

Throughout the course of conducting Medicaid Presumptive Eligibility and ABE applications, confidential personal and demographic data from clients will be collected. I understand that I may not use personal, medical, or demographic client data for any purpose that is not directly related to the fulfillment of my agency's outreach and enrollment responsibilities.

I also understand that I may not disclose personal, medical or demographic client information to any person not directly responsible for ensuring the processing of Medicaid Presumptive Eligibility and ABE applications and/or the delivery of healthcare services to members. Required

Please select the type of user that you are. Required

Hospital Providers

I am a regular user for a provider that is certified to submit a Report of Birth.

I am a regular user for a provider that is certified to submit Health Coverage applications.

I am a regular user for a provider that is certified to submit Hospital Presumptive Eligibility (HPE) applications.

I am a designated agency security administrator for a Hospital that is certified to submit a Report of Birth.

Medicaid Presumptive Eligibility Providers

I am the designated agency security administrator for a provider that is certified to submit Medicaid Presumptive Eligibility (MPE) applications and Family Planning Presumptive Eligibility (FPPE) applications.

I am a regular user for a provider that is certified to submit Medicaid Presumptive Eligibility (MPE) applications and Family Planning Presumptive Eligibility (FPPE) applications.

All Kids Providers

I am the designated agency security administrator for a provider that is certified to submit ABE applications.

I am a regular user for a provider that is certified to submit ABE applications.

Long Term Care Providers

I am the designated agency security administrator for a provider that is certified to upload documents.

I am a regular user for a provider that is certified to upload documents.

Other Providers

I am the designated agency security administrator

Section 2 - ABE User ID and Password

To log in into your provider account, you will need to create a ABE User ID and password. You will need your ABE User ID and password to login to the provider portal.

ABE User ID :

Your User ID must be 5 to 20 letters and/or numbers.

Password :

Your password must be a minimum of 8 characters.

It must contain a minimum of three of the following:

one capital letter,
one lower case,
one special character (! @ # $ % & *), and
one numeral

Passwords cannot be used consecutively. The same password cannot be used for 24 change cycles.

Do not use your User ID or your name.

System Security policies require you to change your password every 180 days.

Please re-type your Password :

We are also asking two "secret questions" that you can use if you ever need to recover your password. Click on the box to choose a question that only you know the answer to. Then fill in your answer. Please remember the answer you give, since you will need to type it in exactly the same way if you lose your password.

Secret Question 1 :

Answer to Secret Question 1 :

Secret Question 2 :

Answer to Secret Question 2 :

Section 3 - Organization Information

You have told us in Section 1 that you are a regular user for a Medicaid Presumptive Eligibility and/or an All Kids provider and/or Long Term Care provider and/or Hospital Presumptive Eligibility provider. Please enter the Provider ID and click the Add button to add multiple Provider IDs.

HPE ID:

- -

Provider ID

You also told us that you're the designated agency security administrator for a Medicaid Presumptive Eligibility and/or an All Kids provider and/or Long Term Care provider and/or Hospital Presumptive Eligibility provider. Please enter the associated Provider ID below. This request will be confirmed by the state before your access rights will be established.

Provider ID Required

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