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New Remittance Forms and Procedures
The Statewide 9-1-1 Board would like to welcome you to our new Payer Express process for remitting 9-1-1 fees in Indiana.
The procedures have changed and it is our hope that these changes will benefit all providers.Please complete all steps of the remittance procedure for each transaction.
1. Complete ALL information requested on the IN911 Provider Remittance Form as either a Word document or a PDF file.
2. Email the completed form to: email@example.com, or send it via fax to (317) 233-0894.
3. Attach documents for write-offs or discrepancies in revenues.
4. Click "remit payment online" below and follow the log-in instructions to complete the financial transaction.
IN911 Provider Remittance Form (Word) (PDF)
If you have questions, please contact our office at firstname.lastname@example.org or by telephone (317) 234-8362.