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Questions? Call Me.  Nick Walterhouse: 813-324-1141

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Once we have received this information we will begin building your new account.

Who Is Completing This New Account Request Form?


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Do You Currently Have Another Account With AnswerFirst?
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Who Should Be Copied on Account Setup Communications?
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Tell Us About The New Account We Are Setting Up
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New Account Setup Information
(The rest of the information you'll be entering is for the account for which we'll be answering phone calls)
You must record the name of your company.

 
New Account Contacts
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Customizing Your Account
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New Account Security Information
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How Would You Like To Receive Your Invoices?



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Please add [email protected] and [email protected] to your personal and/or corporate email "white lists" to insure email is not marked as spam.

 
How Would You Like To Make Payments?




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If you need to restart the authorization process, select "eCheck" as a payment option again.
All eChecks require online access to your bank account for account validation.
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Info for prepay
 
New Account Agreements
-Health Care Providers. Health Care Providers who submit HIPAA transactions, such as claims or patient information, electronically are included. These providers include, but are not limited to: Doctors, Clinics, Psychologists, Dentists, Chiropractors, Nursing homes and Pharmacies.

-Health Plans. For HIPAA purposes, Health Plans include: Health insurance companies, HMOs, or Health Maintenance Organizations, Employer-sponsored health plans, Government Programs that pay for Health Care, like Medicare, Medicaid, and Military and Veterans’ Health Programs.

-Clearinghouses. Clearinghouses include organizations that process nonstandard health information to conform to standards for data content or format, or vice versa, on behalf of other organizations.

If still unsure, please click this link.

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By completing this account signup form, entering my name and selecting "Agree" below, I attest that I have read, understand and agree to immediately enter into and be bound by the Terms Of Service, including the information regarding the use of "call recordings" and AnswerFirst's "caller harassment" policy. I further attest that I have reviewed and understand all of AnswerFirst's Pricing, rates, charges and fees and that I am legally authorized to enter into this agreement and am authorizing AnswerFirst to begin billable services and my account setup, all of which I am financially responsible for.

By completing this account signup form, entering my name and selecting "Agree" below, I attest that I have read, understand and agree to immediately enter into and be bound by BOTH the Business Associate Contract and the Terms Of Service, including the information regarding the use of "call recordings" and AnswerFirst's "caller harassment" policy. I further attest that I have reviewed and understand all of AnswerFirst's Pricing, rates, charges and fees and that I am legally authorized to enter into BOTH of these agreements and am authorizing AnswerFirst to begin billable services and my account setup, all of which I am financially responsible for.

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Under Florida Statute §831.01 it is a felony to forge another's name via written or electronic signature.
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Customer Information
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