DataLink MS

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Eligibility Verification Free Trial
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Free Trial
Please select your free trial option(s)

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. Ensure your email address is correct so that we can contact you. This email address will be our primary contact source for your account.

10 digits
10 digits

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).

Address
Address
City
State/Province
Zip/Postal

Limited Liability Agreement - 14 Days (Case 1)

Please Read the Terms
and Submit Free Trial

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 in 14 days after your approval. There is no Financial Obligation and no Credit Card required.

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.

I have read and agree to the above terms.*

Limited Liability Agreement - 14 Days (Case 2)

Please Read the Terms
and Submit Free Trial

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 in 14 days after your approval. There is no Financial Obligation and no Credit Card required.

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.

I have read and agree to the above terms.*

Limited Liability Agreement - 14 Days (Case 6)

Please Read the Terms
and Submit Free Trial

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 in 14 days after your approval. There is no Financial Obligation and no Credit Card required.

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.

I have read and agree to the above terms.*

Limited Liability Agreement - 30 days (Case 3)

Please Read the Terms
and Submit Free Trial

Limited Liability Agreement

This Agreement is confirmation that you may use our data entry Online Verification at no cost for 30 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 in 30 days after your approval. There is no Financial Obligation and no Credit Card required.

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 30-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.

I have read and agree to the above terms.*

Contact us

Address: San Antonio, Texas

Sales: 1-800-845-0367

Email: info@datalinkms.com

Website: datalinkms.com

Thank you for choosing DataLink Solutions.