EFT / ERA

Do you want to receive electronic claims payments faster than mailing paper checks for free?

There are three easy steps for EFT Enrollment:

1. Fill in the attached EFT Authorization Agreement form.
2. Return the completed form with a scanned or faxed copy of a voided check from your financial institution.
3. Send the form and voided check to [email protected] or fax 262-721-0722. 

To receive ERAs, please submit the following form to [email protected] or fax 262-721-0722.