Contact Us Today!

ezmerp.biz
9800 Mount Pyramid Court, STE 400

Englewood, CO 80112

303-872-2044

Like us on Facebook.

This site provides sample forms:

Plan Document

Corporate Resolution

Welcome Letter

Billing

Explanation of Benefits (EOB)

Claims Report

Aggregate Report

HIPAA Authorization

DORA Colorado Uniform Appilcation

More Info

Plan Document
PlnDocSampleIn735493
PlnDocSampleIn735493.pdf
Adobe Acrobat document [235.6 KB]
Corporate Resolution
resolutionSample+Inc+735493+$282$29
resolutionSample+Inc+735493+$282$29.pdf
Adobe Acrobat document [245.7 KB]
Welcome Letter
welcome+$282$29
welcome+$282$29.pdf
Adobe Acrobat document [4.7 MB]
Billing
eazySampl735493
eazySampl735493.pdf
Adobe Acrobat document [56.1 KB]
Explanation of Benefits (EOB)
eazyHenderson+JH1980abc
eazyHenderson+JH1980abc.pdf
Adobe Acrobat document [169.5 KB]
Claims Report
EZMERP_Claim_Report+$282$29
EZMERP_Claim_Report+$282$29.pdf
Adobe Acrobat document [121.0 KB]
Aggregate Report
aggregate+report
aggregate+report.pdf
Adobe Acrobat document [104.8 KB]
HIPAA Authorization
EZMERP+HIPAA+PRIVACY20130708
EZMERP+HIPAA+PRIVACY20130708.pdf
Adobe Acrobat document [167.1 KB]
DORA Colorado Uniform Appilcation
CUA+2014
CUA+2014.pdf
Adobe Acrobat document [2.8 MB]
Print Print | Sitemap
Customers and Affiliates