
Get the free TX DSNP EFT AUTHORIZATION ENROLLMENT FORM. Accessible PDF
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Aetna Better Health
2777 Sermons Fry, Suite 1450
Dallas, TX 75207
18003068612
Fax 18555968401Instructions for Electronic Funds Transfer (EFT) Enrollment/Change/Cancellation
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What is tx dsnp eft authorization?
The TX DSNP EFT authorization is a form used to authorize electronic fund transfers for Texas Dual Special Needs Plans.
Who is required to file tx dsnp eft authorization?
Healthcare providers and facilities that are enrolled in Texas Dual Special Needs Plans are required to file the TX DSNP EFT authorization.
How to fill out tx dsnp eft authorization?
The TX DSNP EFT authorization form can be filled out by providing all the required information, such as the provider's name, address, banking information, and signature.
What is the purpose of tx dsnp eft authorization?
The purpose of the TX DSNP EFT authorization is to facilitate electronic fund transfers for payments related to Texas Dual Special Needs Plans.
What information must be reported on tx dsnp eft authorization?
The TX DSNP EFT authorization form requires information such as the provider's name, contact information, banking details, and authorization for electronic fund transfers.
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