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Trial Sign-Up (Eligibility Verification Only) –  Enrollment Wizard 

NO COST OR OBLIGATION – (If you decide to not subscribe after the trial period, your login credentials will no longer access the portal)

Questions or to sign up over the phone.  Call one of our friendly customer service representatives at 800-845-0367, Extension 701.

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The wizard will walk you through the enrollment process – you must complete all steps in order to enroll successfully. During this process, you will be asked to supply information that is needed to identify you as well as to each of the Payers that you wish to transact with. The information is kept strictly confidential.

Before you begin…

You should have the following types of information available:

  • Practice/Organization name and address
  • Contact Information including email address
  • Tax ID
  • NPI

Please note that all required fields will be marked by an asterisk(*).

Trial Sign-Up (Eligibility Verification Only) – Enrollment Wizard
  • Limited Liability Agreement

    This Agreement is confirmation that you may use our data entry Online Verification at no cost for 14 days. This offer is only valid to licensed medical Providers. These Services utilize an Internet-based System. No installation is required.

    Your free trial use of the above referenced Services will automatically expire 14 days after your approval. YOU AGREE THAT DATALINK SOLUTIONS MAKES NO WARRANTIES OR REPRESENTATIONS, WHETHER EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, ANY IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO THE ABOVE REFERENCED SERVICES AND/OR INTERNET-BASED SYSTEM AND THAT IN NO EVENT WILL DATALINK SOLUTIONS BE LIABLE TO YOU OR TO ANY OTHER PARTY FOR ANY LOSS, INCLUDING TIME, MONEY, GOODWILL AND CONSEQUENTIAL DAMAGES WHICH MAY ARISE FROM USE OF THESE SERVICES AND/OR SYSTEM DURING YOUR FREE TRIAL USE. THIS OFFER IS SUBJECT TO APPROVAL AND MAY BE REVOKED WITHOUT NOTICE.

    By completing this enrollment, you are agreeing to the above terms and conditions for your 14-day free trial use of our services above specified and you authorize Datalink to set up an account with our clearinghouse on your behalf in order to initiate your free trial.


  • Contact Information

    In order to better service your account in the event there are issues or problems that need to be discussed, please supply contact information. Please make sure your email address is correct so that we can contact you. This email address will be our primary contact source for your account.







  • Tax ID, NPI and Facility Type

    Your facility’s Tax ID (Employer Identification Number) and NPI Number are required for setting up your trial account and submission to some payers during transaction processing.

    IMPORTANT: Please correctly enter the Tax ID and NPI Number to be sent with submissions to payers.

  • Business Demographics

    Enter information about your business (practice or facility).