Patient Information
You will need to enter patient information in the following format:
- State patient's complete ID as written on ID card.
- Key in 8 digit Date of birth (MM/DD/YYYY) (ie: 12/03/1974)
- Key in patient's 10 digit home phone number
To look up Patient Information Press:
Patient Information >>
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Referring Physicians Information
You will need to enter referring physician information in the following format:
- Enter last 4 digits of your health plan ID.
- Enter First 3 letters of your last name
- Enter 10 digit office phone number
- Enter 10 digit office fax number
Referring physician health Plan ID numbers are issued by the Health Plan. For contact information to assist in obtaining a Health Plan ID number, please see the below documentantion:
Provider Relations Information >>
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