How to Receive EFT for Blue Cross Blue Shield of Georgia

Blue Cross Blue Shield of Georgia disburses refunds and other payments to members and employees. If you are one of these members or employees, it is possible to receive your payments through an electronic fund transfer (EFT) directly into your bank account. You must gather some necessary information and complete two forms to do so.

Things You'll Need

• Electronic Funds Transfer enrollment form
• 835 Electronic Remittance Advice Enrollment (ERA) Form
• Copy of a voided check

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Instructions

• 1

  Obtain an Electronic Funds Transfer enrollment form. The EFT form can be found online at the web address listed in the References section or can be obtained at any one of the Blue Cross Blue Shield locations in Georgia.

• 2

  Obtain an 835 Electronic Remittance Advice Enrollment (ERA) form. Each billing service or clearinghouse has its own 835 ERA form which must be obtained by contacting the service directly by phone or through the service's website.

• 3

  Fill out the Electronic Funds Transfer Enrollment form and 835 ERA form. The forms will require the provider name and location, location suffix, tax ID number (a Social Security number can be used in place of this number), an address for the applicant and bank account information. The Location Suffix can be found by looking at a recent Explanation of Benefits from the provider. It is the three-digit number next to your tax ID number.

• 4

  Attach the copy of a voided check to the EFT Enrollment Form.

• 5

  Mail the forms to:

  Blue Cross Blue Shield of Georgia

  3500 Peachtree Road

  EDI Services/GA014-0007

  Atlanta, GA 30326.

  The forms can also be faxed to 404-682-3238 (each form and the voided check must be faxed separately).

• 6

  Wait to receive a confirmation by mail that your enrollment was successful. This may take two or more weeks.