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Account Creation

This form is to create a provider clearinghouse account with Smart Data Solutions. This account will allow you to submit claims, receive ERAs, and check claim status and eligibility for a variety of payers. Before creating an account, please confirm with your office manager that you have permission to do so. If you are a billing service please contact Smart Data Solutions Mon-Fri 9-5 CST at or 855-297-4436 to create an account.

If you have any questions, you may contact our support Mon-Fri 9-5 CST at or 855-297-4436.

Provider Details

Provider Contact Information


Please create a password. It must include at least:
  • 12 characters
  • One uppercase letter
  • One lowercase letter
  • Two numbers
  • One special character
  • No repeating characters