Due to planned OnBoard maintenance occurring between 3:00 a.m. to 6:00 a.m. ET on Monday, July 29, 2024, email and text notifications may not be generated during this period. Please check your dashboards for prior authorization requests (PARs) and PAR responses submitted during this period. All other functionality will be working, including updates to the electronic case folders in eCase.
Web Submission of Claim Forms - Adobe Format
Select the "Load previously saved data" button near the top of the form,
and then select the data file that you previously saved. (i.e. patientName12-31-08.xml) The data from the file will populate the corresponding fields on the form.
Review all sections to be sure the information is accurate.