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What is EFT Change
The EFT Change Form is a business document used by healthcare providers to update or cancel electronic funds transfer settings.
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Who needs EFT Change?
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EFT Change is needed by:
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Healthcare providers looking to change banking details
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Authorized signatories managing financial transactions
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Accounts departments requiring payment updates
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Insurance providers needing updated forms for disbursements
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Providers using Virginia Premier Health Plan for payments
How to fill out the EFT Change
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1.To access the EFT Change Form on pdfFiller, go to the pdfFiller website and search for 'EFT Change Form'.
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2.Open the form to view the interactive fields available for completion.
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3.Before filling out the form, gather necessary details such as your bank name, routing number, and account number.
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4.Click on each empty field to input your information, ensuring you accurately fill in 'Bank Name', 'Routing #', and 'Bank Account #'.
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5.Make sure to provide the correct 'Effective Date of Bank Account Change'.
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6.If required, click to attach a voided check or deposit slip by following the attachment prompts.
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7.Once all fields are completed, review the form for accuracy and completeness.
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8.Use the preview option to make sure all entered information appears correct.
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9.To save your work, click the save icon, and choose your preferred format for download.
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10.If you are ready to submit, select the option to email it directly to Virginia Premier Health Plan or download it for mailing.
Who is eligible to submit the EFT Change Form?
Any authorized representative of a healthcare provider that uses electronic funds transfer can submit the EFT Change Form. It's essential that the person submitting is designated as an authorized signatory.
What documents need to be attached with the EFT Change Form?
A voided check or deposit slip must be attached to the EFT Change Form. These documents serve as proof of the new banking details you are providing.
How do I submit the completed EFT Change Form?
Once completed, the EFT Change Form can be submitted by emailing the filled form to Virginia Premier Health Plan or by printing and mailing it to the appropriate address.
Is there a deadline for submitting the EFT Change Form?
While no specific deadlines are mentioned, it is advisable to submit the EFT Change Form promptly to prevent delays in payment processing.
What common mistakes should I avoid when filling out the form?
Ensure accuracy in all fields, especially the bank details. Double-check the routing and account numbers, and don’t forget to attach the required voided check or deposit slip.
What are the processing times for the EFT Change Form?
Processing times can vary, but generally, expect that changes might take a few business days to reflect in your payment system once submitted.
Do I need to notarize the EFT Change Form?
No, the EFT Change Form does not require notarization. However, it must be signed by an authorized signatory to be valid.
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