Vendor Activation Form, CR 118819

This notification is a reminder for providers to use the correct and current Vendor Activation form when establishing or updating an account with the State of fb88's accounting system. This form is now available to download within the Provider Enrollment Application (PEA) under the Supporting Documents screen. You can access the PEA by going to and signing into your Trading Partner account. Providers may also download the file here.  

Please contact Provider Services with questions: 

  • Call Provider Services at 1-866-690-5585, option 2.