SelectHealth: Provider Benefit Tool Access and ITSA
By George Ruan • October 25, 2026
Use SelectHealth’s official access page to obtain the current forms. If Bomi is preparing the access packet, return your completed signature through Bomi’s secure channel so the same packet stays together.
Instructions checked October 25, 2026 against the official sources below. Menu names can change; use the stated support route if your screen differs.
Sections
1. Open the current forms
Open the official Request Claims Tool Access page linked below. Download both the Login Application and Information Technology Service Agreement (ITSA).
If Bomi has supplied a prepared ITSA, use that copy and its instructions. If you cannot find it, ask Bomi to resend it securely rather than signing a different version.
2. Complete only your part of the packet
Have the practice’s authorized signatory review the ITSA and complete the Health Care Organization signature block, including printed name, title, signature and date.
Locate the signature block by its heading in the actual version you received. Do not rely on a page number copied from a different revision.
Confirm who is completing the Login Application. It identifies the organization, named users and requested tool; for claims/eligibility work the request is Provider Benefit Tool. Do not put requested personal verification fields in an ordinary email reply to Bomi.
3. Return or submit the agreed packet
If Bomi owns preparation, upload the signed agreement through Bomi’s secure upload and let the team complete the remaining access forms. If your practice is submitting directly, SelectHealth’s official page instructs applicants to send the completed forms to providerwebservices@selecthealth.org. Confirm an approved secure delivery method with SelectHealth for sensitive completed fields.
The Login Application says a previously signed ITSA does not need resubmitting. Ask SelectHealth to confirm an existing agreement before producing a duplicate. Questions go to Provider Development at 800-538-5054, option 2.
4. Confirm activation
Follow SelectHealth’s account and two-step-authentication instructions. Ask the named user to confirm they can open the Provider Benefit Tool for the intended organization. Sending the agreement is a submitted access request, not proof that access is active.
Frequently Asked Questions
Where do I get the ITSA?
Use SelectHealth’s official Request Claims Tool Access page, or the prepared copy Bomi sent for your packet.
Is the signature always on page 12?
No. Find the Health Care Organization signature block in the actual agreement version provided.
Sources and illustrated instructions
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