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Minnesota Provider Screening and Enrollment Manual

Minnesota Provider Screening and Enrollment Manual

Manage Profile Identifier

Revised: January 3, 2024

Overview

Your profile identifier is your federal employer identification number (FEIN) or your Social Security number (SSN). You are required to provide either your FEIN or SSN to enroll in Minnesota Health Care Programs (MHCP).

On this page, you can add a new profile identifier or edit an existing profile identifier.

Portfolio/Profile Information

See Portfolio/Profile Information on the Recurring Items page of the Minnesota Provider Screening and Enrollment (MPSE) User Manual.

Profile Identifier

Under Profile Identifier, provide information related to your profile identifier.

Portfolio Type

Use the drop-down list in the Portfolio Type box to select your portfolio type. There are three portfolio types to select from:

  • · Organization – for organizational providers
  • · Individual – for individual practitioners
  • · Direct Support Worker – for individual direct support workers (DSW)
  • Social Security number

    Type your Social Security number (SSN) in the Social Security Number box. Use the format 999-99-9999. If your social security number was entered previously, it will be masked for data privacy and will display as ***-**-****.

    FEIN

    Type your federal employer identification number (FEIN) in the FEIN box. Use the format 99-9999999. If your FEIN was entered previously, it will be masked for data privacy and will display as **-*******.

    Has a Profile Identifier

    By default, Yes is selected for this option. The Minnesota Department of Human Services (DHS) manages this selection and it will not show in your enrollment record until DHS staff reviews and approves your request.

    DHS staff will change this selection to No if there is a reason to delete the existing profile identifier. For example, if the wrong number was typed in.

    Change Effective Date

    In the Change Effective Date box, enter the effective date of the change you are making to the profile identifier in the format of MM/DD/YYYY. You are able to add or edit a change effective date only if your profile identifier is a FEIN. If your profile identifier is a SSN, this box will not appear.

    Supporting Documentation

    The Supporting Documentation box shows the documentation that you uploaded to support your request to change your profile identifier.

    Remove Upload
    Check the Remove Upload box to remove the document that is currently uploaded. This will happen automatically if there is an existing document and you upload a new document.

    Upload Supporting Documentation

    Use the Upload Supporting Documentation box to upload documentation you have to support your request to change your profile identifier. Supporting documentation is not required. Click on the words Upload Supporting Documentation or click on the icon shaped like an eye to open a dialogue box on your computer which will allow you to select a document to upload. MPSE only allows the following document types for upload: PDF, JPG, and PNG.

    Reason for Change Note Actions

    Use Reasons for Change Note Actions to manage notes on your profile identifier.

    Click Edit to add a new note or edit an existing note about your request to change your profile identifier.

    Click View to review the note about changes made to your profile identifier. In view mode, you cannot make edits.

    Profile Identifier History

    Under Profile Identifier History, information related to your profile identifier history is shown. If there has been a change made to your profile identifier, your previous profile identifier and related information along with your current profile identifier appears here.

    Click View to view the note that was made when the request was created to change your profile identifier. The link to view the note will only appear if a note exists. If a note does not exist, this field is blank.

    Continue

    Click Continue to save your changes and go to the next page.

    Cancel

    Click Cancel to go back to the previous page.

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