Provider Membership

Completing this Application for Membership form will generate an invoice and begin your membership immediately. If you need more information about annual dues or have other questions regarding membership, please submit using the Contact Us tab and we will promptly respond to provide information.

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1Type of Organization
2Personal Info
3Additional Persons
4Payment Information
5Finalize
Which membership are you applying for?(Required)
Select Annual Revenue from ID/A Claims (click here for our 2022-23 Dues Policy Statement)