Approved Provider Online Payment - Northeast MSD
Please fill out the following form to pay for your Approved Provider Application online for credit card or check payments. We accept VISA, MasterCard, American Express, Discover and PayPal.
Please complete all the requested information below, select your fee payment and payment type then click submit payment *DO NOT HIT THE BACK BUTTON OR CLICK SUBMIT PAYMENT TWICE* This will cause a duplication of your payment
Late fees notice:
• A late fee of $500.00 is assessed for applications not meeting the self-study application cycle dates (March 1, July 1 & November 1) Extensions up to 3 months may be granted at the discretion of the Northeast MSD Accredited Approver Unit and must be requested in writing with explanation of cause. Extension dates will not change the original approval period. There is no guarantee that applications not meeting cycle dates will be approved prior to Approved Providership expiration.