Provider Request an Account | Allied Benefit Systems

Welcome New Provider Users

What you need to register

Organization or individual provider name and Tax Identification Number
Allied processed claim number and claim date of service
User information, phone number and email address

If you do not have an Allied claim number and date of service, you can skip entering that information. You will be able to enter that information in your Website Account Settings once you have a processed claim number.

Provider Registration

Organization Name

TIN

Phone Number

Claim Number

Date of Service

User First Name

User Last Name

Email Address

Confirm Email

Confirm