Contact Information

Please fill out the information below and we will make the changes requested.

Attention: To update your credit card on file please click on this link.

Add/Remove Logins or Add/Remove EZClaim Company Files

Please indicate if you would like to add or remove a login in this section (example: Please add 2 users with access to Billing and Scheduling OR please remove EZClaim1 from our account). If not adding or removing logins, please enter N/A.

Available Services: Unless you have an agreed upon discount with EZClaim, the following fees apply: Additional user licenses are $119.00 or current rate each monthly (unless otherwise noted) Additional Company Files: $30/ or current rate (unless otherwise noted) Staff training after the Onboarding Graduation will be available as recorded webinars. Individual training sessions are available with expert EZClaim Trainers at $125 per session. Other Services: $200/hour (Example: Assistance with security assessments or anything else outside our standard Onboarding procedure.) Billflash Electronic Statements & Payment Services *Prices and fees are subject to change at our sole discretion.

General Account Change Requests

Please indicate if you would like to change general things on your account such as adding or removing Password Authorities (please list new Password Authority names AND e-mail addresses), changing address of the account, or any other general changes not applicable to other sections.) If not making any general changes, please enter N/A.

Attention: To update your credit card on file please click on this link.

What's Next?

Submit this form. Forms are processed within one or two business days. If you have any questions, please call 877-650-0904.