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Thursday 11/21/2024 12:57 AM CST
Forgot User ID
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Indicates a required field.
Enter the following account information. We will use these values to help identify your account. If we find a match, an email will be sent to your email address on record.
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User Type
Provider Billing Agents
Provider Clerks
Providers
User Type is a required field.
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Trading Partner ID
Trading Partner ID is a required field.
Trading Partner ID must contain alphanumeric values only.
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PIN
PIN is a required field.
PIN must contain alphanumeric values only.
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