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Welcome to Aetna's H1N1 Online Roster Billing Sign-up Help
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Welcome Aetna provider. Please complete the below to sign up for ZirMed Roster Claims submission.

Helpful tips:

  • Currently ZirMed Roster Claims submission is exclusive to Aetna providers.
  • Once enrolled, please see the ZirMed Welcome screen for a link to learn more about receiving Aetna remits or any other ZirMed solution for this and/or other payers.
  • See the Help link for ZirMed Roster Claims Prerecorded Instructions; these will also be accessible from your ZirMed Welcome screen.
  • Consider using your store number in the Account Name to help uniquely identify the account.
  • The Account Administrator is able to do the following:
    • Add users to the system
    • Update personal information about a user
    • Reset passwords
    • Delete users
    • Set permissions
    • Unlock a user
  • The Account Administrator’s email address will receive all account related email communications.
  • Asterisk denotes a required field.

Account Information
* Account Name 
* Account Address 1 
Address 2 
* City    * State     * Zip Code 

Account Administrator
* User Name 
* First Name 
* Last Name 
* Email Address