Early Intervention Electronic Billing Service

 


 

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We Make Billing Childs Play!

Welcome to
The Myka Lynn Corporation's

Early Intervention Electronic Billing Service
Subscription Enrollment

WELCOME Indiana - New Jersey and Louisiana!

Enrollment - Please Complete All Information and Click the Enroll button to Enroll for The Myka Lynn Electronic Billing Service

  • Enroll now to lock in your monthly service fee.  You may cancel at any time, there is no term commitment. Review Pricing at www.mykalynn.com

  • After completing this page we will mail you the pre-completed enrollment documents for both The Myka Lynn Corporation and EDS or Covansys .  These include a user checklist, business associate agreement, user agreement, test file authorization, trading partner agreement (EDS, Covansys) and electronic billing selection statement (EDS, Covansys).
  • Simply review the documents and sign where indicated.  Return the packet to us in the provided envelope along with a check for your 1st months subscription.  We will forward the documents to Covansys and return to you the executed agreements.
  •  Your account should be live within 7-14 days of activation.
  • Your paid subscription will begin once testing is complete and we have activated your account.  You will be notified of your "live" status.  If you become live in the middle of the month, your 2nd months fee will be prorated accordingly.
  • By Clicking Enroll, you are simply requesting a pre-completed enrollment package.  You are not officially enrolled until the documents are signed by both parties.  Remember: There is no risk.  Should you ever decide to stop your subscription you can do so at any time.

Contact Information - * Denotes Required Item


Entity Type
Primary Contact First Name  

Primary Contact Last Name  
Primary Contact Title  
Agency Name, if applicable
DBA Name, if applicable
Email Address  
Mailing Address
 
City  
State
Zip  
Phone Number  

Indiana: Enter EDS 2007# and 2006#

New Jersey & Louisiana Enter Covansys ID (Tax ID or SS #)

 

Agency Only

Active Provider Count

Referring Provider

                                   

© 2004 The Myka Lynn Corporation