WebForm - Password Reset
Step One

Username

Email

Your email address is your username. Please use the email address where your invitation to the portal was received. You may change your email address once you have successfully created your account by going to the Account page.

 

Security Questions

Please answer the following three security questions to validate your identity.
Question
Answer
 
Step One - Questions - Question Two
Question
Answer
 
Step One - Questions - Question Three
Question
Answer
 
Step Two
Select One: I would like to verify my account using...
 

Provider Lookup

This is a secure site. We require unique pieces of information in order to match your portal account to your provider account in our administrative system accurately. We will only require this information now at account setup and possibly in the future if your account was to become locked due to failed attempts at login.
Do you have an Individual NPI?
Provider Individual NPI
Provider Last Four SSN (####)
Provider Full SSN (#########)
Provider Date Of Birth (MM/DD/YYYY)
 

Security Questions

Please answer the following three security questions to validate your identity.
Question
Answer
 
Step Three - Questions - Question Two
Question
Answer
 
Step Three - Questions - Question Three
Question
Answer
 
Step Four
  • 7
    Minimum Length
  • A/a
    Uppercase/Lowercase
  • 0-9
    Number
  • %
    Special Character
Password
Confirm Password