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Application for EMR4 Eligibility Server - Requires using EMR4 Billing Software also.
$99 enrollment fee with 49 cents per inquiry after that paid in advance amounts of $20.
How did you find us? (Web? D/C?) *
Profession
DC
MD
ND NMD
DO
DPM
PA
RN
PT
PhD
LMT
Dealer
Other Provider
Number of Doctors
Number of Clinics
When are you planning
to start?
Today
30 Days
60 Days
Doctor *
First Name and Last Name
Street Address *
City State/Province Zip *
Phone *
Email *
Service desired
Insurance Eligibility Service
Questions, Comments?
Click here to
Notice:
