Medicaid (MMIS) ENROLLMENT:
Two forms are required for access.
Instructions for Confidentiality Agreement and Application to Request Access to DHHS Information Technology Assets: Complete one form for your agency. This is a multi-purpose form to accommodate different types of access. Certain responses related to Medicaid Provider access have been completed, however if a response does not adequately describe your agency, please add additional information or correct the response provided.
Instructions for DHHS External Access Confidentiality Statement: Complete one for each person accessing the site.
Fax (402-742-2353) or mail the completed forms to the Medicaid EDI Help Desk at:
Department of Health and Human Services
Attn: Medicaid EDI Help Desk
P.O. Box 95026
Lincoln, NE 68509-5026
Separate login IDs and passwords are required for each person accessing the site. It is a violation of your agreement to share login IDs and passwords. Contact the Medicaid EDI Help Desk to register staff changes (new staff or staff terminations). Each new member must sign a DHHS External Access Confidentiality Statement.
Passwords are valid for 90 calendar days. When your password expires, you will be prompted to reset the password from the log-in screen. Current passwords may also be revoked when 3 consecutive attempts to log on are unsuccessful.
To establish a new password or change a current password:
Go to: https://dhhs-cpw.ne.gov/cpw/
Enter your assigned ‘SS’ number (user name) and current password.
Select ‘change’ and enter new password.
Confirm new password.
Log off website.
If your password change is not successful, please contact the DHHS Help Desk (402-471-9069) for assistance.
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