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Claim For Payment Submission Portal
This submission portal is to be used for EMS Agencies or EMS Course Sponsors to submit reimbursement vouchers for original courses or refresher programs.
Course Sponsor, EMS Agency, National Registry or CME Voucher
Course Sponsor
EMS Agency
National Registry Proctor
CME Voucher
Submitting Individual Information
Full Name
Company
Email
Phone
Is this submission for a Course, PSE or Both?
Course
PSE
Both
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Upload requirements
One file only.
100 MB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods
.
PSE Score Sheet
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Upload requirements
One file only.
100 MB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods
.
Written Exam Results
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One file only.
100 MB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods
.
Claim For Payment
Upload
Upload requirements
One file only.
100 MB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods
.
Proof of EMT Certification
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Upload requirements
One file only.
100 MB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods
.
Proof of Payment
Upload
Upload requirements
One file only.
100 MB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods
.
Claim For Payment
Upload
Upload requirements
One file only.
100 MB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods
.
CME Reimbursement submissions via this portal are only for those CME recertifications that were not vouchered along with the submission package on the CME Portal.
Submission ID (SID)
?
Vendor ID
Vendor Name
Invoice Number
Invoice Date
Obligation Date
Invoice Amount
Description
Voucher Attachment
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Upload requirements
One file only.
100 MB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods
.
Submit