Updated Enrollment and Billing Support Form
In order to complete requests in a more timely and accurate manner, we've made the following changes to the online enrollment and billing form.
- "Request a copy of bill(s)" has been added to the drop-down menu as a Reason for Inquiry. This option should be used only when requesting a copy of an existing bill or invoice. This will enable a faster turnaround time when only a copy of an existing bill is needed. This Reason for Inquiry should not be used for billing research requests.
- The phone number field on the support form has been updated to now accommodate phone number extensions.
- Depending on your browser, you may be required to click “Upload Files” in order to attach documents to the support form (if that step applies). The instructions have been updated to remind users that they may need to follow this step, which will prevent the request from being closed. ("Closed No Action Taken")
You can access the form in three steps:
If you have any questions, please contact your dedicated account representative.