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Provider Enrollment Applications

Effective May 1, 2010, providers must submit their enrollment application to Molina Medicaid Solutions on the new electronic application form.

To submit an Idaho Medicaid provider application, go to (Molina Medicaid Solutions Web site). Click on the Provider Enrollment link on the left side of the page. A step-by-step guide is located under the User Guide link on the left side of the screen. We recommend you open this guide in a separate browser window before you begin your application. To begin your application, open a new browser window at, click on the Provider Enrollment link on the left side of the page and then click on the New Provider Enrollment Application link in the center of the page. The new enrollment online application is simple to navigate and online help text appears for each field when you hold your cursor over the field. Additional provider enrollment help is available at 1 (866) 686-4272 choose option "0".