DYSERV, INC.
Online Billing Form - step 1 of 4
Hello and welcome to our online billing form!
Notice: If this is the first time you have submitted billing, please be sure you have completed all sign-up information.
Type of service:
Aide per hour (S9122)
RN per hour (S9123)
LPN per hour (S9124)
Home Health Nursing (G0154)
Home Health Aide (G0156)
PT Therapy (S9131)
OT Therapy (S9129)
SP Therapy (S9128)
LISW Therapy (S9127)
Physical Therapy (G0151)
Occupational Therapy (G0152)
Speech Therapy (G0153)
Client first name:
Caresource Provider # (12-digit No punctuation):
Confirmation Email Address (optional):
The following page may take a moment to load, thank you for your patience.