Apply to become a provider
Step 1: Obtain your criminal background check
DHS has assigned certain provider types and specialties to the "high" categorical risk level.
The Affordable Care Act (ACA) requires all providers deemed to be a high categorical level to obtain criminal background checks, which include a Federal Bureau of Investigation (FBI) criminal background check and a Pennsylvania State Police Criminal Record Check.
Any person with a 5% or greater direct or indirect ownership interest in the high risk provider must also submit criminal background check information. You can learn more here.
To obtain a Pennsylvania State Police Criminal Record Check
The Pennsylvania State Police Criminal Record Check department will request the results of the State Police Criminal Record Check from the provider, and any person with a 5% or greater ownership interest, in the provider. You can upload your background check here. You will also be required to submit your results directly to DHS.
If you, or a provider you own, has been placed in the "high" risk level
If you have been notified by DHS that you, or the provider you own, have been classified as a high risk provider, you must be fingerprinted.
Step 1: You will be required to obtain a fingerprint-based criminal background check here.
Step 2: If the banner at the top of the screen does not read OMAP – Medical Assistance Provider Direct/Indirect Ownership Interest or OMAP – Medical Assistance Provider, your background check information will be sent to the wrong office, and you will be required to enroll again.
Step 3: Once registered, you will be assigned a registration code. Please enter that code and the date of your screening into the Electronic Provider Portal application.
Step 2: Apply online or by mail
Applying online:
You can apply online here for a:
- New application – for brand new providers
- New service location applications – for existing providers applying for a new service location
- Revalidation application – for existing providers needing to revalidate their enrollment*
- Reactivation application – for existing providers re-activating a previously closed service location
- Change Request – for existing providers needing to change their current enrollment information
*Providers are required to revalidate their information every five years, and be re-screened by DHS.
Applying by mail
Providers are encouraged to enroll electronically, however, if you must apply by mail please visit the DHS' CHIP Provider Enrollment Information.
Frequently Asked Questions
Yes, at the present time BHHC is not shared on the PRV file, an additional application is required.
If I have an Enrolled Not Paid Provider Eligibility PEP (ENP) enrolled in Medical Assistance, do I need to also complete a CHIP only application? No, you are screened by MA and are eligible to participate with CHIP.
Please use the Children's Health Insurance Program (CHIP) Provider Types and Specialties for Enrollment crosswalk.
No, if you have an approved MA office than you are supposed to enroll all office locations in MA.