Group Sign Up

You have reached this page because you are an existing Avesis group that would like to begin managing your billing and eligibility online. If this is correct, please fill out the form below and select the Submit button.

After Enrollment, You will be able to perform the following:

• view, modify, print and verify your monthly invoices online.
• In addition, your group will maintain all of its eligibility securely online
• All transactions are real-time

Enter your Company Information
Carrier / Group Number:	Company Name:	Telephone:
Who will be administering these online services for your company?  *
First Name:	Last Name:	User Name (to log in):
E-Mail:	Confirm E-Mail:
What month would you like to begin utilizing our online services? October November (The first month you would like to verify an invoice online )

(All fields required)

* NOTE: if the administrator name entered above does not match that of the billing administrator currently on file with Avesis, we must validate this request before proceeding.