Enrollment Portal

What are the possible maximum number of steps for completing the Portal?

• 4

• 5

• 6

• 7

How many tax buckets are there for the states?

• 2

• 3

Answer explanation

Tax Free

State Issued

Self Declared

What is the tentative go live date for the self serve Portal?

• May 2023

• June 2023

• July 2023

• August 2023

Clinic names on which docs must match for a 3-way match?

• MSA+W9+Banking

• T&C+MSA+W9

• MSA+T&C+Banking

Tax classification is on this form.

Routing Number is on this form.

If there is an issue with the Portal, do this

• Call 911

• Call Amir

• Call Haley

• Create an INC request