Manage Enrollment Status

Revised: June 6, 2024

· Enrollment Status

Overview

This page is for informational purposes only and is for use by DHS staff. This shows the current enrollment status for the enrollment record being viewed. Provider Eligibility and Compliance enters the information into the enrollment record and will update the enrollment status if there is a change in MHCP eligibility.

Portfolio/Profile Information

This is a recurring section that appears on multiple MPSE pages for informational purposes only. 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.

Enrollment Status

Under Enrollment Status, information is displayed about the enrollment status(es). If this is a new enrollment record that has not yet been reviewed by Provider Eligibility and Compliance, this section will not have any information to display.

View
Click View on any enrollment status to go to the Enrollment Status page. From this page, you can view your enrollment status. You will not be able to make any changes on this page.

Create New Enrollment Status

The Create New Enrollment Status button appears but is not enabled. Provider Eligibility and Compliance uses it to add an enrollment status to your record after reviewing your application or to update your status should your eligibility change for any reason.

Continue

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

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Enrollment Status

Overview

On this page, you can view the enrollment status.

Portfolio/Profile Information

This is a recurring section that appears on multiple MPSE pages for informational purposes only. 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.

Enrollment Status

The Enrollment Status section displays the enrollment status details.

Enrollment Status

The Enrollment Status box will display one of the following enrollment statuses:

· Active, 1

· Active - Pending Termination, 5

· Active reinstated, 2

· Active do not pay, 3

· Affirmative ACT Comply, R

· Change of Ownership, F

· Denied PCA not eligible, O

· Denied for Background Check, Y

· Denied for other reasons, P

· Denied not eligible, N

· Denied two prov numbers, L

· Deny/Term Failed FP and Visit, 9

· Deny/Term Failed Fingerprint, 7

· Deny/Term No Pay Enrol Fee, 6

· Deny/Term SAM Exclusion Provider, 8

· Deny/Term other state Medicaid, X

· Encounter only, 4

· Invalid license, K

· License expired, D

· License revoked, C

· MCO Only Contracted Non FFS, M

· Medicaid authority, A

· Medicare Medicaid exclusion, E

· Medicare termination, B

· No claims activity, G

· Inactive - Voluntary termination

· Owner Authorized Person Exclusion, V

· Pend-license/Cert verify, W

· Pending DHS Approval, U

· Pending enrollment, I

· Pending missing documentation, T

· Pending signed agreement, S

· Term not eligible, Z

· Term-Bus closed or prov deceased, H

· Term-noncompliant-documentation term, Q

· Voluntary termination, J

Provider Eligibility and Compliance explains the enrollment status in a letter sent to the provider when they apply an enrollment status to the record. If this letter is unavailable, call the Provider Resource Center for assistance.

Status Date

Status Date will display the effective date of the enrollment status. The date will be displayed in MM/DD/YYYY format.

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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