Update Insurance Information or Patient Information

Fields marked with an asterisk * are required.

Account number
be sure to include your prefix starting with DS-

* *
Patient's name *
Patient's date of birth / / (mm/dd/yyyy)*
Name of your insurance company listed on the ID card *
Policy holder ' s name *
Policy holder ' s date of birth / / (mm/dd/yyyy)*
Policy or identification number *

Group number if applicate
Note: not all insurance companies listed group number

Mailing address to submit a claim *
or
Electronic payor ID number listed on the identification card
Insurance telephone number *
 

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Medi-Bill is independently owned physicians billing service. We provide professional medical billing services to a multitude of physicians, physician groups and ambulatory surgical centers.