MCO Provider Information

Posted: December 2, 2021

Overview

Use this page to review a provider’s current enrollment information. The information displayed is the most current information on file. The information displayed is for view only for the Managed Care Organization.

This page opens in a new tab. You will need to close the page to return to the MHCP Provider Search page.

Steps to review an individual or organization’s provider information:

Step 1 Log in to MN–ITS with your MCO username.

Step 2 Click the link for the Minnesota Provider Screening and Enrollment (MPSE) portal in the left-side navigation. (If you do not see the link, contact your MNITS administrator.) This brings you to the MCO Home page.

Step 3 Click Search for MHCP Provider.

Step 4 Locate the provider in the MHCP Provider Search section, click View under the Provider Profile Actions. This will open the Provider Information page.

Provider Information

Here you will be able to view the following provider information:

· Legal Name. The name of the provider or organization, as listed on the provider record.

· First Name, Middle Name (if no middle name, select the indicator box) and Last Name for an individual provider.

· Social Security Number. The 9-digit Social Security Number assigned to the provider

· FEIN. The 9-digit Federal Employer Identification Number (FEIN) assigned to the provider or organization.

· NPI/UMPI. The 10-digit National Provider Identifier (NPI) or Unique Minnesota Provider Identifier (UMPI) assigned to the provider.

· Enrollment Record Type. The Enrollment Record Type box displays the description and the 2-digit code that identifies the type of provider or organization.

· Street Address 1. The first line of the physical location address for the practice location; or primary location for individual providers.

· Street Address 2 Type / Data. The second line of the physical location address for the practice location; or primary location for individual providers.

· City. The city of the physical location address for the practice; or primary location for individual providers.

· State. The state of the physical location address for the practice; or primary location for individual providers.

· Zip Code. The 5-digit zip code of the physical location address for the practice; or primary location for individual providers.

· County / Tribe. The name of the county or tribe of the physical address for the practice; or primary location for individual providers.

· Phone Number The 10-digit phone number for the provider.

· Fax number. The 10-digit fax number for the provider.

You will see the following additional sections that display the enrollment information for the individual or organization provider. For further explanation about these sections, review the “PECD File Instructions for Managed Care Organizations.”

· Additional Enrollment Questions

· Credentials

· Agreements and Addendums

· Specialty Codes

· Enhanced Service Codes

· Packaged Service Codes

· Owners or Authorized Person or People