Additional Insurance Companies  

Request for Adding Insurance Company or Managed Care Company

This is a free service. Please access our website, www.onlyeclaims.com and download updates.

This information will be available in 2 working days after onlyeclaims.com receives your information. You must place the updates in the same folder as your original location for the onlyeclaims.com program. After download is complete, return to the onlyeclaims.com setup program to select the new insurance companies that you accept at your location and enter the doctor’s provider numbers. Refer to the initial instructional video sent to you for the setup.

Name of Insurance Company
Street
Street 2
City ST Zip
Contact Person
Phone Ext
Fax
Email
Website

Comments

(Please include the states for which you provide services at your location)

If you are submitting multiple insurance companies, you only have to provide this information once.

 

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