Become a Provider
Become a Contracted Provider
We appreciate your interest in MHS and are excited to set up your office as a participating provider. If you would like more information, please fill out the online form on this page. An MHS representative will reach out to you shortly to discuss contracting options for your office.
If you are a provider who is part of a contracted entity, contact your MHS Provider Relations Representative. Use our online Contact Us, or call MHS at (877) 647-4848.
Non-Contracted Provider Set-Up
Please complete the online form on this page, or download the PDF from the MHS Provider Forms page to complete and submit later. All submissions must include a completed W9. Set-up may take up to 45 to 60 calendar days after we receive your submission.
To begin set up with MHS, you must be enrolled with Indiana Medicaid and have an Indiana Medicaid provider number. You can enroll online at indianamedicaid.com.