Medical & Hospital EFT Enrollment Forms
The Change Healthcare EFT service enables customers to have payments from EFT participating payers deposited electronically into their bank accounts at no cost.
Please visit https://payerenrollmentservices.changehealthcare.com/
to enroll for the following payers below:
- Adventist Health System/West (95340)
- Advocate Health Center (36320)
- Advocate HPO (65093)
- AGIA INC. (95241)
- Allegeant (52193)
- Associated Administrators, LLC. (13788)
- Auxiant (26202)
- Banner Health (MediSun)/Blue Advantage (77078)
- Banner Plan Administration (12X42)
- Baptist Health Plan (61124)
- Baptist Health Plan Advantage (BHPMA)
- Caremore Health Plans (CM001)
- Centene Management Company (64073)
- Central PA Teamsters Health and Welfare Fund (23626)
- Coastal TPA Inc (77052)
- Colorado Access 84129
- Community First Health Plan (42723)
- Core Administrative Services (58231)
- Elderplan, Inc. (31625)
- Everence formerly Mennonite Mutual Aid (35605)
- Guardian Life Insurance Company of America (64246)
- HCH Administration (37111)
- Health Care Payers Coalition (34193)
- Health Design Plus (34158)
- HealthyCT , Inc - Brokers (66866)
- Kaiser Foundation Health Plan, Inc. (40523)
- Lovelace Salud (SX159)
- Lovelace Sandia Health Plan (90328)
- MedPartners Administrative Services (35205)
- MIchigan UFCW 27401
- MMA (35316)
- Ohio Benefit Administrators (R0755)
- Paramount Health Care (SX158)
- Pinnacle 33081
- Preferred Care Partners (Miami, Fl) (65088)
- Premier Eye Care 65054
- S & S Healthcare Strategies/ Secure Health Plan of GA (31441)
- Secure Health Plans of Georgia (28530)
- South Indiana Health Operations HMO (SX142)
- Synermed (75299)
- Teachers Health Trust 88019
- Texas Children's Health Plan (Medicaid) EFT (75228)
- Texas Childrens Health Plan(CHIP) EFT (76048)
- United Administrative Services, Inc. (94174)
- United Group Programs (59189)
- University of Utah Health Plans (65250)
- WEBTPA (75261)
- Welfare and Pension Admin. Service (91136)
- Wells Fargo TPA (37272)
For all other EFT Payers, please click on the EFT Participating Payer List below to verify if payer is participating and then click on EPayment Request forms link below to enroll for EFT.
- EFT Participating Payers - A listing of EFT participating payers
- EFT FAQs - Frequently asked questions regarding EFT
New Provider/Existing Providers
Quick Post Advisor™
Additional EFT information
- EFT Enrollment Data Element Descriptions - CORE-required Maximum EFT Enrollment Data Set
- CAQH CORE Payment & Remittance (CCD+/835) Reassociation Rule
- Opt In to receive CSA's specific to EFT