Sign up for e-referral or change a user

To ensure continued access for current e-referral users

You must login at least once every 180 days to keep you user ID active. If your user ID is not working, fax a request on company letterhead to 1-800-495-0812 asking for the ID to be reconnected. Include the user ID, your name and email address, and have it signed by the authorized individual in the office. For additional help, please call the Web Support Help Desk at 1-877-258-3932.

To sign up as a new e-referral user

Each prospective e-referral user must have a Provider Secured Services ID (sometimes referred to as a web-DENIS ID) and password to use the e-referral application.

  • If your office has access to Provider Secured Services but not e-referral, complete the appropriate Secured Access Application below — either Facility or Professional — and fax or mail the completed form to the fax number or address listed on the form. You do not need to complete the Use and Protection Agreement, because you previously completed the agreement to obtain access to Provider Secured Services.


  • If you don't currently have access to Provider Secured Services, follow the instructions below for your provider type to get access to e-referral:

Professional providers

  1. Download the Professional Service Secured Access Application (PDF) and complete the required fields. Make sure you check the box on Page 2 in the "e-referral Access (BCN only)" column next to the name of each person requesting e-referral access.
  2. Download the Use and Protection Agreement (PDF) and complete the required fields.
  3. Fax or mail the completed forms to the fax number or address listed on the forms.

Facility providers

  1. Download the Facility Secured Access Application (PDF) and complete the required fields. Make sure you check the box on page 2 in the "e-referral Access (BCN only)" column next to the name of each person requesting e-referral access.
  2. Non-hospital facilities should complete the Use and Protection Agreement (PDF)
  3. Fax or mail the completed forms to the fax number or address listed on the forms.

Billing services

  1. Download the Billing Service Secured Access Application (PDF) and complete the required fields. Make sure you check the box in the "e-referral Access (BCN only)" column next to the name of each person requesting e-referral access.
  2. Download the Use and Protection Agreement (PDF) and complete the required fields.
  3. Fax or mail the completed forms to the fax number or address listed on the forms.

To reassign a Provider Secured Services ID or deactivate an ID (for provider offices that currently have e-referral access but have had staff changes and need to reassign or deactivate a user ID)

  • If your office already has access to e-referral and one of the staff has left and you would like to reassign the ID please follow the instructions for reassignment.
  • If you would like to deactivate a Provider Secured Service ID please follow the instructions for deactivation.

To add or remove providers from the office or facility (for current e-referral users that need to add or remove practitioners from the scope of the user's access)

If your office already has access to e-referral and you have new providers on staff, please fill out the applicable form below.