Resource Center

Download forms and guides for credentialing, contracting, updates, and direct deposit.
Some forms may contain sensitive information. Submit completed forms only to the official emails listed below.

How the Process Works

Follow these steps to complete your provider enrollment

Confirm Medicaid ID

01

Confirm your Medicaid enrollment ID (PEP/PRMMIS) is active (if applicable).

Complete Credentialing

02

Complete credentialing on the official credentialing platform.

Submit Package

03

Once approved, submit your contracting package.

Receive Agreement

04

Contracting prepares and sends the agreement.

Sign & Setup

05

Both parties sign and provider is set up in the payment system.

Welcome Letter

06

Provider receives the welcome letter / confirmation.

Credentialing

Credentialing is required prior to contracting.

Credentialing Platform

Access the official credentialing portal to complete your application.

Credentialing Support

Need help with the credentialing process? Contact our support team.

Contracting

Select your provider type and download the required forms.

Individual Provider Documents

Corporation Documents

Where to Send

Demographic Updates

Update Your Information

Use this form to add, change, or remove a location, or to update your mailing address.

Direct Deposit

Set Up Direct Deposit

Complete the ACH/EFT form, attach a voided check or deposit slip, and email it to:
provider_vital_ach@planmenonita.com

Provider Guidelines

Reference only. No submission required.

Frequently Asked Questions

Find answers to common questions about the provider enrollment process.

Individual Providers are solo practitioners enrolling under their personal NPI, while Corporations are business entities (LLC, Inc., etc.) that may have multiple providers under a group NPI. Corporations require additional documentation such as Ownership & Disclosure forms and W-9.

For contracting documents (request forms, W-9, ownership forms), send to providerservices@pns-pr.com. For ACH/EFT enrollment and direct deposit forms, send to provider_vital_ach@planmenonita.com.

After submission, our Contracting team reviews your documents for completeness. Once approved, we prepare and send the provider agreement for signature. After both parties sign, you are set up in the payment system and will receive a welcome letter with confirmation.

The most common missing items are: voided check or deposit slip for ACH/EFT forms, missing signatures on required documents, incomplete W-9 forms for corporations, and outdated license or certification copies.

Download the Demographic Changes Form from the "Demographic Updates" section above. Complete all required fields indicating whether you are adding, changing, or removing a location, or updating your mailing address. Submit the completed form to providerservices@pns-pr.com.

For general inquiries, contact us at info@pns-pr.com or call (787) 782-6050. For credentialing-specific questions, use the Credentialing Support option in the Credentialing section. Our team is available during business hours to assist you.

Yes, credentialing must be completed and approved before you can proceed with contracting. This ensures all your qualifications and certifications are verified before entering into a contract agreement.

Processing times vary depending on the completeness of your submission. Complete packages with all required documents typically take 2-4 weeks. Incomplete submissions will require additional time for follow-up and resubmission.

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