Enroll your patients in ACCESS4Me

There are 2 ways to enroll:

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ACCESS4ME ONLINE PORTALEnroll your patients through the ACCESS4Me provider portal. A one-stop online destination for reimbursement and patient support.

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  1. Log in to the ACCESS4Me Provider Portal
  2. Select Patient Enrollment and complete the enrollment form.Appropriately select the attestation and signature options before submission
  3. Click “Continue” and “Submit” to send forms

*Requires registration and e-signature setup.

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FAXComplete, sign, and fax the ACCESS4Me Program enrollment form.
Fax: 833-281-7416

Download the form


Receive your benefits summary

2 business days:

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Once a completed enrollment form is received, your practice will receive a complete benefits summary within 2 business days.

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Portal Services

  • Real-time information on approval status
  • Electronic upload of patient documentation
  • Electronic signatures
  • Simple and easy navigation
  • Track patient status in real time
  • Secure messaging with your Reimbursement Specialists


Connect with your Field Reimbursement Manager for more information about ACCESS4Me and a demo of the Provider Portal.