Document Uploader

This page offers a convenient and secure way to upload documents to our office for review and processing.









  • Select all document types that apply to your submission.  
  • To add an additional file under each type, click "Add another [Document Type] document."
  • Total upload document(s) size limit per submission is 25 MB.
  • Acceptable file types are: .doc, .docx, .xlsx, .xls, .pdf, .jpg, .png, .txt, .jpeg
  • To avoid possible issues with the upload, the file name should just include letters and/or numbers. Avoid spaces and special characters such as ():;-?!{}[]|#$%&@*
Audit Documentation

There is a limit of 5 attachments in a single upload.

If provided on source communication or by Patient Advocate.

Enrollment Applicaiton

There is a limit of 5 attachments in a single upload.

If provided on source communication or by Patient Advocate.

Health Insurance Plan Details

There is a limit of 5 attachments in a single upload.

If provided on source communication or by Patient Advocate.

Power of Attorney Documentation

There is a limit of 5 attachments in a single upload.

If provided on source communication or by Patient Advocate.

Program Agreements/HIPAA Documentation

There is a limit of 5 attachments in a single upload.

If provided on source communication or by Patient Advocate.

Reenrollment Application

There is a limit of 5 attachments in a single upload.

If provided on source communication or by Patient Advocate.

Waitlist Application

There is a limit of 5 attachments in a single upload.

If provided on source communication or by Patient Advocate.

Reimbursement Request

There is a limit of 5 attachments in a single upload.



If provided on source communication or by Patient Advocate.

Other

There is a limit of 5 attachments in a single upload.

If provided on source communication or by Patient Advocate.

If you are experiencing technical difficulty or need assistance uploading documentation, please contact a Patient Advocate.
MondayFriday
855-845-3663
8 a.m. - 7 p.m. ET


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