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Get Benson's Direct Bill Account Application Form
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How to fill out the Benson's Direct Bill Account Application Form online
Filling out the Benson's Direct Bill Account Application Form online can streamline your process for establishing a direct billing account. This guide provides clear, step-by-step instructions to help you navigate through each section effectively.
Follow the steps to successfully complete the application form.
- Press the ‘Get Form’ button to obtain the form and open it in the online editor.
- Begin by entering the date in the designated field at the top of the form. Ensure the date is accurate and in a recognizable format.
- In the 'Company Name' field, provide the official name of your company as it should appear on invoices. This is important for billing accuracy.
- Fill in the 'Account Name' with the name you wish to appear on all invoices. This could be the same as the company name or a specific department.
- Enter your contact information, including your phone and fax numbers, as well as an email address for correspondence regarding the account.
- Select the property or properties where you would like to establish direct billing by checking the appropriate boxes.
- Indicate where you would like the billing to be sent by filling in the appropriate address lines, including the city, state, and zip code.
- Check the categories that are approved for this account. Ensure you only select the relevant services your organization will utilize.
- Specify the preferred method of billing by checking the appropriate option: email, fax, or mail. Also, indicate if a P.O. number is required.
- List any other names authorized to use this account to ensure that all personnel are recognized.
- Review the payment terms stating that payment is due net within thirty days. Make sure all information is correct before proceeding.
- Sign the document in the 'Authorized Signature' field and print your name underneath it. Include the date of signing.
- Once all sections are completed, save your changes. You may also download, print, or share the form as needed.
Complete your application form online today for a seamless billing experience.
Related links form
Let's quickly review the basics: Direct bill means the insurance carrier bills the policyholder and the policyholder pays the carrier directly. In agency bill, the agency bills the insured, collects the premium payment(s) and pays their MGA or the carrier.
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