InstaMed Order Form - Payer Payments - CareSource 2026

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  1. Click ‘Get Form’ to open the InstaMed Order Form in our platform.
  2. Begin by filling out the 'Customer Information' section. Provide your primary contact details, including name, title, phone number, and email address. Ensure that all fields are completed accurately to avoid delays.
  3. Next, move to the 'Remittance Delivery' section. Indicate how you wish to receive electronic remittance advice (ERA) by listing your clearinghouse if applicable. You can also opt for SFTP delivery by checking the corresponding box.
  4. In the 'NPIs' section, enter your Billing Provider NPI(s). If you have Service Provider NPI(s), include them as well. Only list NPIs that should receive payments routed to you.
  5. Proceed to fill in the 'Bank Account Information'. Provide your bank name, routing number, and account number. Remember that a voided check or bank letter is required for verification.
  6. Finally, review all information for accuracy before signing in the designated signature field. Your electronic signature will be treated as a handwritten one for validity.

Start using our platform today to complete your InstaMed Order Form quickly and efficiently!

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You need to use only reliable software solutions with strong security compliance to approve your documents electronically. DocHub is just the type of service you need! It stores data on Amazon Web Servers and complies with all necessary security requirements and eSignature regulations, so it’s a reliable way to eSign your instamed payer list or other documents using this tool.

You may quickly fill out, modify, and even eSign your instamed provider utilizing DocHub. Create a new account and start your free trial. After that, you may upload the file with the form and easily make all the required edits. No need to print on paper or use a third-party application to sign it, as you can place your electronic signature on your document quicker through DocHub.

The InstaMed Healthcare Bill Payments solution lets patients make payments to their healthcare providers through pay.instamed.com or health plan member portals including UnitedHealthcare and Anthem.
For Electronic Payments Statements (EPS), we partner with InstaMed and Optum Pay, to provide the delivery of electronic claims payments and remittance advice information.
Integrated ERA/EFT Payer List Payer NamePayer ID Block Vision 13374 BlueLink TPA 55026 BMS Access Support TLG Bright HealthCare BRGHT75 more rows

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