EPayment Enrollment Authorization Form - Providers - Select Health of South Carolina ePayment Enroll: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by completing the EFT Authorization Form. Ensure you provide an original signature and include a government-issued ID on your legal entity's letterhead.
Fill in the contact information for your financial institution, including the name, address, and phone number. Attach a bank authorization letter or a voided check.
On page 2, provide mandatory Provider Contact Information 1 & 2. These are essential for any inquiries regarding EFT/ERA information.
Indicate if you wish to enroll for all TIN & NPI EFT Payers as specified on pages 5 & 6. If applicable, list individual payers starting from page 7.
Once completed, sign and email your form as a PDF attachment to EFTEnrollment@changehealthcare.com or fax it to 615.238.9615.

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What is the payer ID for First Choice Select Health of South Carolina?

Submit claims through electronic data interchange (EDI) for faster, more efficient claims processing and payment. Select Healths EDI payer ID number is 23285.

What is the phone number for First Choice Select health of SC?

Use these phone numbers to get in touch with First ChoiceSM by Select Health of South Carolina. Call Member Services, toll free at 1-888-276-2020 (TTY for hearing impaired 1-888-765-9586), for questions about the topics below.

Who owns First Choice Health?

First Choice Health is a 100% provider-owned healthcare organization, serving clinicians and health systems with health benefits and network solutions for more than 35 years. We couple best-in-class administration and service excellence with proprietary provider network design.

Is First Choice Next Medicaid?

First Choice Next (Individual Plans On and Off Exchange) It offers plans to individuals or families in select counties who do not have coverage through their employers, and do not qualify for Medicare or Medicaid.

What is the phone number for Healthfirst customer service?

You can also call our Member Services Representatives at 1-888-260-1010 (TTY 1-888-542-3821), or for Signature (HMO) Member Services team, call 1-855-771-1081 (TTY 1-888-542-3821), 7 days a week, 8am8pm (October through March) and Monday to Friday, 8am8pm (April through September).