{"id":860,"date":"2020-02-18T21:56:14","date_gmt":"2020-02-18T21:56:14","guid":{"rendered":"https:\/\/ptchoice.com\/?page_id=860"},"modified":"2022-12-06T19:23:52","modified_gmt":"2022-12-06T19:23:52","slug":"update-account-information","status":"publish","type":"page","link":"https:\/\/ptchoice.com\/for-clinicians\/update-account-information\/","title":{"rendered":"Update Account Information"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"860\" class=\"elementor elementor-860\" data-elementor-settings=\"{&quot;ha_cmc_init_switcher&quot;:&quot;no&quot;}\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-91df179 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"91df179\" data-element_type=\"section\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-02124b9\" data-id=\"02124b9\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-fa774a2 elementor-cta--skin-cover elementor-widget elementor-widget-call-to-action\" data-id=\"fa774a2\" data-element_type=\"widget\" data-widget_type=\"call-to-action.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-cta\">\n\t\t\t\t\t<div class=\"elementor-cta__bg-wrapper\">\n\t\t\t\t<div class=\"elementor-cta__bg elementor-bg lazyload\" style=\"background-image:inherit;\" role=\"img\" aria-label=\"formsimage\" data-bg-image=\"url(https:\/\/ptchoice.com\/wp-content\/uploads\/2020\/03\/formsimage-1024x683.jpg)\"><\/div>\n\t\t\t\t<div class=\"elementor-cta__bg-overlay\"><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-cta__content\">\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h2 class=\"elementor-cta__title elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tUPDATE YOUR ACCOUNT INFORMATION\t\t\t\t\t<\/h2>\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-53d40ca elementor-section-full_width elementor-reverse-mobile elementor-section-height-default elementor-section-height-default\" data-id=\"53d40ca\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-f73b747\" data-id=\"f73b747\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a9219a7 ha-mode--compact ha-direction--right elementor-widget elementor-widget-ha-list-group happy-addon ha-list-group happy-addon-pro\" data-id=\"a9219a7\" data-element_type=\"widget\" data-widget_type=\"ha-list-group.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n        <ul class=\"ha-list-wrap\">\n            \n                <li class=\"ha-list-item  elementor-repeater-item-eb79b1d\">\n\n                                        <a class=\"ha-link\" href=\"https:\/\/ptchoice.com\/test-menu\/\">\n                    \n                        <div class=\"ha-item-wrap\">\n\n\t\t\t\t\t\t\t                                <div class=\"ha-icon icon\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>                                <\/div>\n\n                            \n                            <div class=\"ha-text\">\n\t\t\t\t\t\t\t\t\t<!-- title tag start -->\n                                    <h4 class=\"ha-list-title\">\n                                        Clinical Test Directory                                                                            <\/h4>\n\t\t\t\t\t\t\t\t\t<!-- title tag end -->\n\n                                                            <\/div>\n\n                                                            <div class=\"ha-direction\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"hm hm-play-next\"><\/i>                                <\/div>\n                            \n                        <\/div>\n\n                                        <\/a>\n                    \n                <\/li>\n\n            \n                <li class=\"ha-list-item  elementor-repeater-item-8499dc7\">\n\n                                        <a class=\"ha-link\" href=\"https:\/\/ptchoice.com\/test-menu\/\">\n                    \n                        <div class=\"ha-item-wrap\">\n\n\t\t\t\t\t\t\t                                <div class=\"ha-icon icon\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>                                <\/div>\n\n                            \n                            <div class=\"ha-text\">\n\t\t\t\t\t\t\t\t\t<!-- title tag start -->\n                                    <h4 class=\"ha-list-title\">\n                                        Look Up Specimen Requirements                                                                            <\/h4>\n\t\t\t\t\t\t\t\t\t<!-- title tag end -->\n\n                                                            <\/div>\n\n                                                            <div class=\"ha-direction\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"hm hm-play-next\"><\/i>                                <\/div>\n                            \n                        <\/div>\n\n                                        <\/a>\n                    \n                <\/li>\n\n            \n                <li class=\"ha-list-item  elementor-repeater-item-06b4472\">\n\n                                        <a class=\"ha-link\" href=\"https:\/\/ptchoice.com\/bill-pay-insurance\/\">\n                    \n                        <div class=\"ha-item-wrap\">\n\n\t\t\t\t\t\t\t                                <div class=\"ha-icon icon\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>                                <\/div>\n\n                            \n                            <div class=\"ha-text\">\n\t\t\t\t\t\t\t\t\t<!-- title tag start -->\n                                    <h4 class=\"ha-list-title\">\n                                        Contracted Insurance Plans                                                                            <\/h4>\n\t\t\t\t\t\t\t\t\t<!-- title tag end -->\n\n                                                            <\/div>\n\n                                                            <div class=\"ha-direction\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"hm hm-play-next\"><\/i>                                <\/div>\n                            \n                        <\/div>\n\n                                        <\/a>\n                    \n                <\/li>\n\n            \n                <li class=\"ha-list-item  elementor-repeater-item-b11cd0b\">\n\n                                        <a class=\"ha-link\" href=\"https:\/\/ptchoice.com\/request-a-specimen-pickup\/\">\n                    \n                        <div class=\"ha-item-wrap\">\n\n\t\t\t\t\t\t\t                                <div class=\"ha-icon icon\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>                                <\/div>\n\n                            \n                            <div class=\"ha-text\">\n\t\t\t\t\t\t\t\t\t<!-- title tag start -->\n                                    <h4 class=\"ha-list-title\">\n                                        Request a Specimen Pick-up                                                                            <\/h4>\n\t\t\t\t\t\t\t\t\t<!-- title tag end -->\n\n                                                            <\/div>\n\n                                                            <div class=\"ha-direction\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"hm hm-play-next\"><\/i>                                <\/div>\n                            \n                        <\/div>\n\n                                        <\/a>\n                    \n                <\/li>\n\n            \n                <li class=\"ha-list-item  elementor-repeater-item-c66ef0e\">\n\n                                        <a class=\"ha-link\" href=\"https:\/\/ptchoice.com\/for-clinicians\/update-account-information\/\">\n                    \n                        <div class=\"ha-item-wrap\">\n\n\t\t\t\t\t\t\t                                <div class=\"ha-icon icon\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>                                <\/div>\n\n                            \n                            <div class=\"ha-text\">\n\t\t\t\t\t\t\t\t\t<!-- title tag start -->\n                                    <h4 class=\"ha-list-title\">\n                                        Update Account Info                                                                            <\/h4>\n\t\t\t\t\t\t\t\t\t<!-- title tag end -->\n\n                                                            <\/div>\n\n                                                            <div class=\"ha-direction\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"hm hm-play-next\"><\/i>                                <\/div>\n                            \n                        <\/div>\n\n                                        <\/a>\n                    \n                <\/li>\n\n            \n                <li class=\"ha-list-item  elementor-repeater-item-03c1b5d\">\n\n                                        <a class=\"ha-link\" href=\"https:\/\/ptchoice.com\/for-clinicians\/order-supplies\/\">\n                    \n                        <div class=\"ha-item-wrap\">\n\n\t\t\t\t\t\t\t                                <div class=\"ha-icon icon\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-smile\"><\/i>                                <\/div>\n\n                            \n                            <div class=\"ha-text\">\n\t\t\t\t\t\t\t\t\t<!-- title tag start -->\n                                    <h4 class=\"ha-list-title\">\n                                        Order Supplies                                                                            <\/h4>\n\t\t\t\t\t\t\t\t\t<!-- title tag end -->\n\n                                                            <\/div>\n\n                                                            <div class=\"ha-direction\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"hm hm-play-next\"><\/i>                                <\/div>\n                            \n                        <\/div>\n\n                                        <\/a>\n                    \n                <\/li>\n\n                    <\/ul>\n\n        \t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-87a13ed\" data-id=\"87a13ed\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6f2aece elementor-widget elementor-widget-heading\" data-id=\"6f2aece\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">ACCOUNT UPDATE FORM<\/h6>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7007753 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"7007753\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" id=\"SU2\" name=\"Account Change Request Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"860\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"7007753\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAccount Number or Company Name:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_1 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tChange Requested By:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_1]\" id=\"form-field-field_1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Full Name, Title\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_befd013 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_befd013\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_befd013]\" id=\"form-field-field_befd013\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Email Address\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_2 elementor-col-100 elementor-field-type-select-multiple elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tUpdate Type(s)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_2][]\" id=\"form-field-field_2\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\" multiple=\"\">\n\t\t\t\t\t\t\t\t\t<option value=\"Add Provider\/NPI\">Add Provider\/NPI<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Remove Provider\/NPI\">Remove Provider\/NPI<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Update Address\">Update Address<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Add Additional Location\">Add Additional Location<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Change Contact Number\">Change Contact Number<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Change Fax Number\">Change Fax Number<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Change Resulting Method\">Change Resulting Method<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Requisition Edits\">Requisition Edits<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Other\">Other<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-message elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-message\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tChange Details\/Notes for Patient's Choice Lab staff:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[message]\" id=\"form-field-message\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_3 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIf changes are not immediately needed- when will you need them completed by?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_3]\" id=\"form-field-field_3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Please enter effective date of change(s) being made here.  Put today&#039;s date if changes are immediate.  \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-field_5 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFile Upload (optional)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_5]\" id=\"form-field-field_5\" class=\"elementor-field elementor-size-sm  elementor-upload-field\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_4 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFile upload notes:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_4]\" id=\"form-field-field_4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"what are these file for?\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha elementor-field-group elementor-column elementor-field-group-field_21f98ee elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_21f98ee\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LeIEZUUAAAAAI96hgC1UWw1UJj0dbRIFqfX1yMH\" data-type=\"v2_checkbox\" data-theme=\"light\" data-size=\"normal\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\" id=\"UpdateAcct\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Submit Request<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>UPDATE YOUR ACCOUNT INFORMATION Clinical Test Directory Look Up Specimen Requirements Contracted Insurance Plans Request a Specimen Pick-up Update Account Info Order Supplies ACCOUNT UPDATE FORM<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":237,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-860","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/pages\/860","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/comments?post=860"}],"version-history":[{"count":11,"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/pages\/860\/revisions"}],"predecessor-version":[{"id":4038,"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/pages\/860\/revisions\/4038"}],"up":[{"embeddable":true,"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/pages\/237"}],"wp:attachment":[{"href":"https:\/\/ptchoice.com\/wp-json\/wp\/v2\/media?parent=860"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}