The ERA Setup Form

Click to download and complete the ERA setup form

EFT / direct deposit links

• Anthem BCBS EFT and Direct Depost: https://solutions.caqh.org/bpas/Default.aspx?ReturnUrl=/bpas/default.aspx/
• GHI EFT and Direct Deposit: https://www.emblemhealth.com/Providers/Provider-Resources/Provider-Toolkit/Electronic-Funds-Transfer-and-Electronic-Remittance-Advice-EFT-ERA
• CIGNA EFT: https://www.cigna.com/healthcare-professionals/resources-for-health-care-professionals/doing-business-with-cigna/electronic-fund-transfer
• Optum EFT for United Healthcare and AARP: https://myservices.optumhealthpaymentservices.com/registrationSignIn.do
• Optum EFT physical form if you do not want to use website: https://www.optum.com/content/dam/optum/resources/publications/eps-enrollment-form.pdf
• Tricare East and Tricare for Life EFT: https://edi.wpsic.com/edir/Provider
• Mutual of Omaha EFT: https://www.mutualofomaha.com/pnc-faq.php
• Humana: EFT for Humana is available on the Humana website. You must register with a username and password on the website: www.humana.com