Tip: Some of the information displayed on this page is read-only and cannot be changed.Use this page to view and/or update specific and detailed information about a provider's billing entity.
Tip: Some of the information displayed on this page is read-only and cannot be changed.
The following information on this page is read-only and cannot be changed:
Billing Entity Name displays the name of the billing entity.
Tax ID displays the current tax identification number of the billing entity.
Status displays the billing entity’s current status (such as Active or Inactive).
Legal Status indicates whether the billing entity is currently enrolled as an Independent or an Agency.
Address displays the current address information for the billing entity.
City displays the name of the city in which the billing entity is currently located.
State/Zip displays the name of the state and the ZIP code in which the billing entity is currently located.
Phone displays the primary phone number for the billing entity.
Mobile displays the mobile phone number for the billing entity.
Phone2 displays the secondary telephone number for the billing entity.
Phone3 displays an alternate phone number for the billing entity.
Fax displays the fax number for the billing entity.
EFT Status indicates whether the billing entity's EFT status is currently Active or Inactive.
The following information on this page can be entered and/or updated as necessary:
In Email, enter or update the email address for the billing entity. You can enter up to 50 characters in this text box. This is required information whenever the billing entity has options selected for email notifications.
In Contact, enter or update the name of the primary contact person for the billing entity. You can enter up to 65 characters in this text box.
Click the following button(s) as necessary:
Click Reset to clear any unsaved changes and restore the previously displayed information.
Click Back to return to the previous page.
Click Save to save information that has been changed.
Note: You can click the tabs along the top of the page to view and/or update additional information about the billing entity.
Click the following link(s) to see how to complete a task step-by-step: