This form is to create a provider clearinghouse account with Smart Data Solutions. This account will allow you to submit claims, receive ERAs, and check claim status and eligibility for a variety of payers.
Before creating an account, please confirm with your office manager that you have permission to do so. If you are a billing service please contact Smart Data Solutions Mon-Fri 9-5 CST at firstname.lastname@example.org or 855-297-4436 to create an account.
If you have any questions, you may contact our support Mon-Fri 9-5 CST at email@example.com or 855-297-4436.