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Pre-Service Review for Out-of-Area Members
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Audit Report
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Find a Doctor
Find a Lab
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Payment
Direct Deposit/EFT Registration
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PA Registration Portlet
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User ID
Must be
8 to 20 characters
Must contain
at least 1 letter
Cannot contain special characters
Password
Must be
at least 8 characters
Must be
GOOD
or better on strength meter
Cannot be your
User ID
Consider a
"passphrase"
instead of a password
(Example: theskyisbluetoday)
Password Strength:
Confirm Password
First Name
Last Name
Telephone
Ext
Cell Phone
Same as Telephone
Email
Confirm Email
User Roles
Select the role(s) that best describe your job functions:
Billing/Insurance
Front Desk/Intake/Scheduling
Nurse or Clinical Care/Support
Physician/Healthcare Provider
Practice/Business Administrator
Precertification/Referrals
Provider Enrollment/Credentialing
Quality Management/Incentive Program
Third-Party Administrator/Billing Service
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