Manage Medicare Enrollment Information

Revised: January 18, 2024

Medicare Enrollment Information

Overview

This page will appear if you selected Yes to the question “Are you, or is this facility enrolled with Medicare?” on your Enrollment Record Information page. If you answer Yes to this question, you will be required to input your Medicare enrollment information on this page. If you or the facility is not enrolled with Medicare, go back to the Enrollment Record Information page and select No to the question “Are you, or is this facility enrolled with Medicare?”

Depending on the provider type you are requesting to enroll as, you may be required to be enrolled with Medicare before enrolling with Minnesota Health Care Programs (MHCP). To find out if this is required for your provider type, review the Enrollment with MHCP page of the MHCP Provider Manual.

Use this page to manage your record’s Medicare enrollment information. Click Add Medicare Enrollment Information to add new information. From the User Actions column, click View to review existing information, or click View/Edit to make changes to existing information. The View/Edit link will only appear when a user has selected the “Create a New Request” button to start an MPSE Request.

Portfolio/profile information

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

Enrollment Record Information

This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Enrollment Record Information on the Recurring Items page of the MPSE User Manual.

Manage Medicare Enrollment Information

The Manage Medicare Enrollment Information section shows your existing Medicare enrollment information. If you have not added Medicare enrollment information, this section will not have any information to display.

View/Edit
Click View/Edit to go to the Medicare Enrollment Information page. From this page, you can review and edit your existing Medicare enrollment information.

View
Click View to go to Medicare Enrollment Information page. From this page you can view the details of your Medicare enrollment information, but you will not be able to make any edits or changes when using this option.

Delete
Click Delete to delete your Medicare enrollment information. You will only be able to delete information that has been added in your current request.

Add Medicare Enrollment Information

Click Add Medicare Enrollment Information to add new Medicare enrollment information.

Continue

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

Cancel

Click Cancel to go back to the previous page.

Medicare Enrollment Information

Overview

This page appears if you click Add Medicare Enrollment Information, View, or View/Edit, on the Manage Medicare Enrollment page.

Portfolio/profile information

See Portfolio/Profile Information on the Recurring Items page of the MPSE User Manual.

Enrollment Record Information

This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Enrollment Record Information on the Recurring Items page of the MPSE User Manual.

Medicare Enrollment Information

In the Medicare Enrollment Information section, view, edit, or add your Medicare enrollment information.

Medicare ID Number

Enter your Medicare ID number in the Medicare ID Number field. Your Medicare ID number must be between 6 and 10 alphanumeric characters.

Is this your primary Medicare ID?

Select Yes if the Medicare ID number you have entered is your primary Medicare ID. Select No if it is not.

You can add multiple Medicare ID numbers. If you answered Yes to being enrolled with Medicare on the Enrollment Record Information page, you must disclose your primary Medicare ID number and you may only have one primary Medicare ID number.

Medicare Enrollment Begin Date

Enter the effective date of your Medicare enrollment in the format of MM/DD/YYYY in the Medicare Enrollment Begin Date field.

Medicare Enrollment End Date

Enter the end date of your Medicare enrollment in the format of MM/DD/YYYY in the Medicare Enrollment End Date field. If your Medicare enrollment is current, leave this field blank.

Continue

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

Cancel

Click Cancel to go back to the previous page.