Updating Electronic Funds Transfer (EFT) - Provider Web Portal Quick Guide

Note: The address on the EFT change must match the billing address on file.

Providers are encouraged to check the billing address prior to submitting an EFT change. This information can be found in a maintenance request on the "Address Changes" panel.

The EFT information from revalidation or enrollment is used, but if EFT information has changed since enrollment, it needs to be updated.

1. Login to Provider Web Portal.
2. Click EFT/ERA (835) Enrollment.
   
3. Click EFT Enrollment Application link.

4. Click Continue.

5. Complete all required fields and click Continue.

6. Attach a letter on the provider’s letterhead. It must
   • Include the business or individual provider name
   • Must be dated within six months of the submission date
   • List the name of the bank
   • List the account and routing number
   • Be hand-signed by an authorized representative

One of the following two options must also be attached:

1.  
   • Voided Check
     • A photocopied or scanned image of an actual check is required. It cannot be an image from a website.
     • Letter from the bank verifying the account and routing number

7. Click Continue.

   

8. Sign the Agreement.

   Type name into the signature box and click Review.

   

Print a copy for records and then click Submit.

7. 

   Record the EFT Application Tracking Number. It is needed to check the status of the EFT application.

   The new EFT information should go into effect within two weeks. Paper checks will be sent for the next two weeks.

   

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