Transcription of Dental Electronic Funds Transfer (EFT) Authorization …
{{id}} {{{paragraph}}}
Example: barber
Dental Electronic Funds Transfer (EFT) Authorization …
Category Code PRIN GR-68960 (5-15) Page 1 of 4 Dental Electronic Funds Transfer (EFT) Authorization agreement We d like you to enroll in Electronic Funds Transfer (EFT). EFT is a free and secure way for you to receive your payments faster. You ll no longer have to wait for checks to arrive in the mail. Aetna can issue EFT s to all healthcare provider types, including those receiving capitation. And, EFT doesn t change our overpayment policies and procedures. If you are overpaid, we ll send you a letter asking for a refund by check. Use the following guide when completing your ERA/EFT enrollment forms. Fields with an asterisk are required; sections left blank or illegible will delay processing.
Category Code – PRIN GR-68960 (5-15) Page 1 of 4 Dental Electronic Funds Transfer (EFT) Authorization Agreement We’d like you to enroll in Electronic Funds Transfer (EFT).
Loading..
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document:
Related search queries
Electronic, Electronic Funds, Electronic Funds Transfer (EFT) Authorization Agreement Enrollment/Change/Cancel, Electronic Funds Transfer, AUTHORIZATION AGREEMENT, Change, Electronic Funds Transfer (EFT) Authorization Agreement, EFT Enrollment Authorization Agreement, EFT enrollment, Provider Information Change, Nevada, Authorization, Transfer, Electronic Remittance Advice Agreement, ELECTRONIC REMITTANCE ADVICE