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Provider Type Checklist

Last updated on

Requirements

Providers must complete the following electronic application pages within the PEMS Enrollment application:

Provider Information

Client Panel

Disclosures

Accounting/Billing

W9

EFT

Attachments

Agreements

Identification

Hold a valid United States issued Auto insurance policy

Hold a valid Driver’s License

Individual Transportation Participants must submit the following additional documentation:

Electronic Funds Transfer (EFT) Notification and a copy of a voided check or a signed letter from the bank. This is to have electronic payments sent to your bank account.