Miscellaneous AR Department Billing Source Add/Update
Department Name
*
As it will appear on invoices
Billing Source Code
*
For modification requests, please enter your Billing Source Code below. If this is a new request, please select NEW.
NEW
Billing Inquiry Phone Number
*
As it will appear on invoices
Primary Billing Type
*
Goods
Services
Billing Method
*
I will generate invoices from another system
I will enter invoices manually
Primary Billing Specialist
The primary person who will create invoices, request customer setup or modification, report on or look up billing and payment activity (one per department/source)
Billing Specialist Name
*
First
Last
Billing Specialist Emplid
*
Billing Specialist Phone
*
Billing Specialist Email
*
Billing Authority
The management level person ultimately responsible for billing activity for this department
Billing Authority Name
*
First
Last
Billing Authority Emplid
*
Billing Authority Phone
*
Billing Authority Email
*
Others Who Will Need Access
Please list all others who will need access for requesting customer records, bill entry, printing, or reporting.
Name
Emplid
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Miscellaneous AR Department Billing Source Add/Update