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CarePortal Registration
Primary User
Please enter account information for your Primary CarePortal User.
First Name *
Last Name *
Title *
E-Mail Address *
Confirm E-Mail Address *  
Registration Type
Registering as a Referring Physician requires a participating physician's NPI, Tax ID, and Last Name. Once registered, you will be able to submit Prior Authorization Requests, lookup the status of existing Prior Authorization Requests, and verify Member Eligibility.
Registering as a Rendering Facility requires a participating facilities NPI, Tax ID, and Zip Code. Once registered, you will be able to lookup the status of existing Prior Authorization Requests, and verify Member Eligibility.
* Password must be at least 8 characters in length, and contain at least one upper case character, one lower case character, and one non alpha numeric character. Characters <, >, / and \ cannot be used.
Password *
Confirm Password *