Avenda Health

 

Unfold AI Reimbursement Support Program

 

New Office Enrollment Form

REQUIRED: Click here to complete a Business Associate Agreement (BAA) with your enrollment

 

Provider Enrollment - Avenda Health

Portal User Information

User Contact Name
User Contact Name
First
Last

Practice Information

Practice Address
Practice Address
City
State
ZIP Code

Physician Information

Facility/Hospital Information

Facility/Hospital Address
Facility/Hospital Address
City
State
ZIP Code

Onboarding Call Availability

Please select your timezone:
Time EST (Option 1)
Time EST (Option 2)
Time CST (Option 1)
Time CST (Option 2)
Time MST (Option 1)
Time MST (Option 2)
Time PST (Option 1)
Time PST (Option 2)

 

PROGRAM SUPPORT:

MONDAY–FRIDAY 8:30AM–5:00PM EST
PHONE: 860-967-0515  FAX860-321-1465
EMAIL: UnfoldAI@priahealthcare.com