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Fiscal Intermediary Contact Us Form

Complete the below inquiry form with any questions or queries you might have regarding PPL or our Fiscal Intermediary Solutions.

Note: Please keep in mind that communications via email over the internet are secure to the best of our ability. Please do not include any Personal Identifying information such as your birth date, SSN, or personal medical information in the form submission below. Communications via our website is only a precursor to the communications you may have with our Customer Service Agents in the future.


Fiscal Intermediary Interest Contact Us

The name of the business or organization you are affiliated with.
Please complete this field using the following format (555) 123-4567
Please provide any additional detail you believe to be relevant. (Do not include PII in this space.)
Please confirm you agree for us to process this request.