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Members: We’ve upgraded the login process for the Allied Member Portal. Click Sign In to update your account.
Members: We’ve upgraded the login process for the Allied Member Portal. Click Sign In to update your account. To login, enter your account number and password and click on the Press to Login button.
Provider Forms. Claim Form - Medical. Claim Form - Dental. Claim Form - Vision. Formulary Drug Removals. Formulary Exclusion Prior Authorization Form. Claim Submission Cover Sheet. HIPAA Authorization Form. Retail Pharmacy Prior Authorization Request Form.
Members: We’ve upgraded the login process for the Allied Member Portal. Click Sign In to update your account.
With your online member portal you have access to: Digital ID Card. Find care and costs. Review coverage and claims. Manage spending. Sign In or Create an Account. If you received a Continuation of Benefits notification or are already enrolled in COBRA, please visit the Continuation of Benefits Coverage Portal here.
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.
Provider Access & Services. Allied provides you with service and support via phone or online access through our provider self-service site. Submit a Claim. Acquire a copy of the member's ID card. Send the original, fully itemized bill to the claims address shown on the member's ID card.
