Account Registration for DME Suppliers

Please use this form to help us to create your account. We will contact you via email when this is done.

The workflow for new registrations is this:

1) Complete this form and provide Authorization Document from NPI/PTAN Holder (if required)

2) We will create your account and you will receive login information from

3) Additional communication may be required for customization.

Training videos and walkthrough guides can be found HERE.

Full list of pricing options

The Eligibility Solution requires an NPI. 

The Same or Similar Solution requires an NPI and PTAN.




Account information


Eligibility information

Please fill out the following if you are planning to run eligibility transactions

(if more than one NPI, please email us this list at, and indicate if you need CMS approval)

Additional Information