Metroplus eft enrollment 2026

1. Click ‘Get Form’ to open the metroplus eft enrollment in the editor.
2. Begin by reviewing the form carefully. Fill in all requested information, including your Vendor Name, Tax ID Number, and NPI Number. Ensure accuracy to avoid processing delays.
3. In the contact section, provide your Billing Address, Contact Name, Email Address, Phone Number, and Fax Number. This information is crucial for communication regarding your enrollment.
4. Next, complete the banking details section. Enter your Bank Name and Bank Address accurately. Include your Bank Routing Number and Checking Account Number. Attach a copy of a voided check to verify these details.
5. Once all fields are filled out correctly, review the entire form for completeness. If required, sign in blue ink where indicated. Do not use signature stamps.
6. Finally, submit your completed form by mailing or faxing it to MetroPlus Health Plan at the provided address or fax number.

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