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The document is a confidential InstaMed Order Form for Payer Payments, which allows healthcare providers to register for electronic funds transfer (EFT) and electronic remittance advice (ERA) from listed payers. It includes instructions for completing the form, customer information requirements, bank account details for payment deposits, and an agreement section for electronic signatures. The form emphasizes that incomplete submissions will not be accepted and provides contact information for support.

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Versions	Form popularity	Fillable & printable
2019	4.1 Satisfied (20 Votes)
2017	4.1 Satisfied (43 Votes)

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What is the difference between EOB and EFT?

What Is an EFT? An electronic funds transfer, or EFT, is the electronic message used by health plans to order a financial institution to electronically transfer funds to a providers account to pay for health care services.

What is ERA EFT?

What is ERA EFT? Electronic remittance advice (ERA) is an electronic version of the explanation of benefits (EOB) for claims payments. Electronic funds transfer (EFT) transmits funds for claims payments directly from a health plan into your bank account.

What is EFT in medical billing?

Electronic Remittance Advice (ERA) The ERA transaction supplies information about. the payment to the health care provider, including any adjustments. to claims and other payments based on factors like: Contract agreements.