Replace paper checks with electronic payments transferred directly into a designated account.
Benefits of Electronic Funds Transfer (EFT)
Reduced administrative costs
Secure transactions that enhance cash management
Maximized cash flow
Most efficient claim payment method
Do not use the below form for EFT requests. Instead, visit the Facility or Provider Maintenance Application on our Availity Provider Portal.
Complete the EFT Authorization Form.
Submit separate forms for organizations with multiple provider numbers. We will work with your bank to complete a three-week testing process. You’ll then receive a message and/or voided check letting you know that the EFT is complete.
Submit another EFT Authorization Form if the information needs to be changed. We will conduct another test period if there is a change to your depository routing number or designated bank.
Email us or call 800.874.8433, option 4 with any questions.