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NH Medicaid Provider Information

Provider Revalidation

All enrolled New Hampshire Medicaid providers must revalidate their enrollment information every five years, in accordance with Section 6401 of the Affordable Care Act. NH Medicaid providers were reenrolled beginning in the spring of 2012 in preparation for the new MMIS Health Enterprise System. Therefore, New Hampshire’s 5-year revalidation will start in June of 2017. In general, providers will be due to revalidate their information no later than five years from their enrollment date with New Hampshire Medicaid.

The provider revalidation process will be conducted exclusively online through the MMIS Portal. When it is time to revalidate your enrollment information, you will receive a revalidation notice through the mail and it will also be posted on your MMIS Message Board. Providers will have 60 days from the date of the revalidation letter to complete and submit their provider revalidation. The MMIS Portal will not allow a provider to begin their revalidation until their provider number has been selected for revalidation.

It is critical that providers keep their MMIS login credentials current. If a current user has not logged into their MMIS account for 30 days, the user will get a message that their account is inactive. The user has to call the NH Provider Call Center at 866-291-1674 to activate their account. If the user has not logged into MMIS for 90+ days, the system will drop the user ID because of inactivity and the provider has to do the following steps:

  1. Go to the MMIS Portal and Click on Documents and Forms. You do not have to log in to the site to access the below form.
  2. Scroll down and print the NH MMIS Health Enterprise Portal Registration Form
  3. Complete the form and either mail or email it to the address at bottom of the form, or fax the form to: 866-446-3318.

It is also important that providers keep their mailing address up to date to ensure that they receive their mailed revalidation notice. If your mailing address has changed and has not been updated in MMIS, please follow the below steps to correct your address:

  1. Go to the MMIS Portal and Click on Documents and Forms
  2. Scroll down and print the Change of Information Form, dated 10/4/2011.
  3. Complete the form and either mail it in to the address at bottom of the form or
    fax the form to: 866-446-3318.
For more information, please read the Provider Revalidation FAQs Adobe Acrobat Reader Symbol

General Information for Providers

All providers of NH Medicaid covered services must be enrolled as a NH Medicaid provider with Xerox to bill medical or pharmacy claims for NH Medicaid recipients. You can contact Xerox via their website https://nhmmis.nh.gov or call them at 1-866-291-1674 or (603) 223-4774 to become an enrolled provider.

If you have questions on if a NH Medicaid covered service requires a prior authorization (PA) please visit Xerox's website and select downloads to obtain all prior authorization forms for services.

If you have questions on prescription drug coverage and clinical prior authorizations please visit Magellan's website at: https://newhampshire.magellanmedicaid.com.
To check eligibility for a NH Medicaid recipient please call 1-866-291-1674 and follow the prompts.

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New Hampshire Department of Health and Human Services
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