Submit a Support Case

To submit a support case fill out the form below.

All fields, unless indicated, are required.

Contact InformationPractice Name
First Name
Last Name
Email Address (Kareo Login)
Phone Number
Additional InformationWhat do you have a question about
Date of Service
Copy/Paste Rejection Message (optional)
Clearinghouse Name (optional)
Clearinghouse Tracking Number (optional)
Have you had other claims for this patient and/or payer process previously
Encounter ID from most recently accepted claim
Insurance Company Name
Services you are enrolling forPlease select atleast one checkbox.Electronic Claims
ERA
Eligibility
Provider's Name (optional)
Payer ID (optional)
Check Number
Check Amount
Have you received any ERA's from this payer previously?
Date Check or Bank Deposit Was Received
Expected Date of ERA
Invoice Number (optional)
Provider Name
Patient Name (optional)
Claim ID (optional)
Description