An official website of the United States government
The Manage Authorized Representative page allows an Account Manager (AM) to request updates to Authorized Representative (AR) information for the listed Responsible Reporting Entity (RRE) ID.
This page shows information currently associated with the AR for this RRE ID and all update requests submitted. If no request has been submitted, none will be shown. You can request updates to the AR information by entering it into the fields.
Note: If a request is currently pending, the AR information fields will be read-only.
| Field | Description |
|---|---|
| Authorized Representative Request History | - |
| Received | Date the request for updates was submitted. |
| Decision | Decision for the request. Possible values: Duplicate Request Pending Review Record Not Updated Record Updated |
| Decision Date | Date the request was closed. |
| Authorized Representative Information | - |
| First Name | First name of the current AR. |
| Last Name | Last name of the current AR. |
| Job Title | Job title of the current AR. |
| Street 1 | Street address for the current AR. |
| Street 2 | Second line, apartment or unit number for the AR. (Optional) |
| City | City for the current AR. |
| State | State for the current AR. |
| Zip Code | Zip code for the current AR. |
| Telephone | Phone number for the current AR. |
| Fax | Fax number for the current AR. |
| E-mail Address | Email address for the current AR. Note: This email address cannot match the email address associated with an existing S111 AM or AD. If the entered email address matches the email address associated with an S111 AM or AD, the system will display an error message and you cannot proceed until the edit has been resolved. |
Re-enter E-Mail Address | Re-type the email address for the current AR. |
Click Cancel to return to the RRE Information Detail page without submitting these updates.
Click Continue to submit your request for changes. Once a request has been submitted, the system will display a confirmation pop-up window. From this window, click Confirm to submit your request and return to the RRE Information Detail page or click Cancel to return to the Manage Authorized Representative page without submitting these updates.
Note: If this information has not been updated on the S111 Coordination of Benefits Secure website within 7 business days, please contact an EDI Representative by phone at (646) 458-6740 or email at COBVA@bcrcgdit.com
July 2025
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