eft attestation and registration guide...2019/12/09 · registration guide december 2019...

EFT Attestation and Registration Guide

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December 2019

AmeriHealth HMO, Inc. • AmeriHealth Insurance Company of New Jersey


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Table of Contents

NaviNet® Open-enabled providers EFT registration and ongoing maintenance instructions ....... 3

Non-participating providers EFT registration instructions ........................................................... 9

Reassociation of Electronic Remittance Advice (ERA/835) and EFT payment ..........................12

Missing or late EFT payment .....................................................................................................12

Learn more ...............................................................................................................................12


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NaviNet® Open-enabled providers EFT registration and ongoing maintenance instructions The NaviNet web portal (NaviNet Open) offers online registration and allows ongoing maintenance of account information for all participating providers. In this guide you will find instructions on how to complete the attestation form, register for EFT (electronic fund transfer), and edit your banking account information.

In order to ensure the EFT Attestation and Registration transaction works seamlessly, users will need to have certain AmeriHealth-required URLs listed as trusted URLs in their browser’s trusted site set-up.

We encourage you to share the Optimizing Your Browser and Adding Trusted Sites Guide with your IT department and work with them to optimize your browser and add trusted sites. We ask that users review their current trusted site set-up and update as necessary.

Your designated NaviNet Open Security Officer is automatically provided access to the EFT Attestation and Registration transaction. Additionally, your designated NaviNet Open Security Officer manages access to the EFT Attestation and Registration transaction for all end users associated with the office by selecting Manage User Permissions under the Administration option offered through Plan Central.

EFT Attestation and Registration EFT Attestation and Registration is a financial transaction designed to allow payment by electronic means rather than conventional paper-based payment methods, resulting in faster payments and reduced administration costs. AmeriHealth supports EFT for participating providers who are capable of accepting funds electronically.


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Once enabled, select ePayment from the AmeriHealth Workflows menu, and then EFT Attestation and Registration.

The EFT Attestation and Registration Provider Selection screen will display. If you have not previously attested as an EFT Responsible Party, you will be prompted to select the billing providers for whom you are responsible.

Once you have made your selection, you will be prompted to attest by checking I accept and selecting Submit.

After you have submitted your attestation, you will be permitted to submit a new EFT enrollment, modify an existing EFT arrangement, and/or cancel an EFT arrangement.


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New EFT enrollments To submit a new EFT enrollment, select New Enrollment from the Action drop-down menu.

Then check the box next to the appropriate provider name and select Next.

You will then be prompted to enter the following information:

• financial institution routing number (can be found on your account check, see example below);

• type of account at financial institution (checking or savings); • provider’s account number with the financial institution (can be found on your account

check, see example below); • confirmation of account number with financial institution; • authorized signature (check the box); • requested EFT start date (i.e., date you wish to begin receiving EFT – you are permitted to

enter the current date or a future date).


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After entering all required information, select Submit. You will be asked to confirm your submission. If you respond “no,” you will be permitted to modify the entered information. If you respond “yes,” you will be presented with a confirmation.

Change enrollment You can also use the EFT Attestation and Registration transaction to modify EFT information. To do so, select EFT Attestation and Registration from the ePayments option in the Workflows menu. You will be presented with a list of provider group(s) for which you have previously attested. You will have the option to select and attest to additional providers as needed. If you do not need to select and attest to additional providers, select Next at the bottom of the screen.

Next, select Change Enrollment from the Action drop-down menu.

You will then need to select the provider group(s) for whom you are modifying EFT information and then select Next.


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You will be prompted to enter the following information:

• financial institution routing number; • type of account at financial institution (checking or savings); • provider’s account number with the financial institution; • confirmation of account number with financial institution; • authorized signature (check the box); • requested EFT start date (i.e., date you wish to initiate the change – you are permitted to

enter the current date or a future date).

After entering all required information, select Submit. You will be asked to confirm your submission. If you respond “no,” you will be permitted to modify the entered information. If you respond “yes,” you will be presented with a confirmation (see example on page 5).


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Cancel enrollment You can also use the EFT Attestation and Registration transaction to cancel EFT enrollment. To do so, select EFT Attestation and Registration from the ePayments option in the Workflows menu. You will be presented with a list of provider group(s) for which you have previously attested. You will have the option to select and attest to additional providers as needed. If you do not need to select and attest to additional providers, select Next at the bottom of the screen.

Next select Cancel Enrollment from the Action drop-down menu.

You will then need to select the provider group(s) for whom you are canceling the EFT arrangement and then select Next.


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You will be prompted to enter the following information:

• authorized signature (check the box); • requested EFT cancel date (i.e., date you wish to cancel the EFT arrangement – you are

permitted to enter the current date or a future date).

After entering all required information, select Submit. You will be asked to confirm your submission. If you respond “no,” you will be permitted to modify the entered information. If you respond “yes,” you will be presented with a confirmation (see example on page 5).

If you have questions about EFT attestation or registration, contact our Provider eBusiness team through our online Provider eBusiness Inquiry form for AmeriHealth New Jersey and AmeriHealth Pennsylvania.

Non-participating providers EFT registration instructions The Electronic Funds Transfer Enrollment Form – For non-participating providers (EFT Enrollment Form) allows providers not participating in the AmeriHealth network the ability to not only register for EFT, but allows for ongoing maintenance or cancellation.

Completing the EFT Enrollment Form In order to complete the EFT Enrollment Form, which can be accessed on our dedicated EFT webpage, you must:

• enter all fields on the form; • make sure to enter the contact information so that AmeriHealth can contact that person with

any questions on the form; • complete a separate EFT Enrollment Form for each bank account.

Make a copy of a voided check After you complete the necessary fields on the EFT Enrollment Form, you will need to make a copy of a voided check. Bank account verification letter on bank letterhead is also acceptable. AmeriHealth needs this information to verify the bank name, routing and account number.

https://fhnportal.amerihealth.com/providerinquiry/ahnj/dashboard

https://fhnportal.amerihealth.com/providerinquiry/ahpa/dashboard

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http://provcomm.amerihealth.com/ProvComm/ProvComm.nsf/PreviewOnBrowser/FBB528B6D4A56F6E8525848D006DE687!OpenDocument


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Upload completed EFT Enrollment form and copy of voided check Please use our online Provider eBusiness Inquiry form for AmeriHealth New Jersey and AmeriHealth Pennsylvania. to upload the completed EFT Enrollment Form and bank account verification, see instruction below: 1. Select Electronic Funds Transfer.

2. Fill out all required information on the form marked with a red asterisk (*).

Important steps when filling out the rest of form.

• Select Register for EFT radio button.




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• Choose Select Files to upload the required documents.

• Click the Submit button to submit the request.

• A confirmation will then be prompted on the screen.

• A confirmation email will be sent.

A member of our Provider eBusiness team will contact you within three business days to ensure that all required information was submitted on the form. Once, AmeriHealth receives all necessary information, your request will be completed within 30 calendar days. A Provider eBusiness analyst will monitor your request and will send you an email confirmation to the email address provided on this form once your EFT request is completed.


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Reassociation of Electronic Remittance Advice (ERA/835) and EFT payment Providers have the ability to automate their patient account posting and reconciliation with the associated electronic payment through use of an Electronic Remittance Advice (ERA/835) and EFT. Providers who receive payment for claims via EFT and also receive the 835 transaction must contact their financial institution to arrange for the delivery of the EFT payment data that is needed for re-association of the payment and the 835. The table below defines the payment data needed for reassociation and where that data is located in both the banking system’s CCD+ (EFT) format file and the 835 transaction:

EFT payment data Banking system’s CCD+ (EFT) format file

835 transaction data

Effective entry date Record 5, Field 9 BPR16

EFT amount Record 6, Field 6 BPR02

Payment related information Record 7, Field 3 TRN segment (Payment/EFT trace number)

Missing or late EFT payment If and EFT payment has not been received after four business days of receipt of the corresponding ERA/835 file, contact our Provider eBusiness team through our online Provider eBusiness Inquiry form for AmeriHealth New Jersey and AmeriHealth Pennsylvania. AmeriHealth defines business days as Monday through Friday, excluding holidays. For EFT, AmeriHealth follows the bank holiday schedule. The electronic funds will be available the next business day following the bank holiday.

Learn more If you have questions about EFT attestation or registration, contact our Provider eBusiness team through our online Provider eBusiness Inquiry form for AmeriHealth New Jersey and AmeriHealth Pennsylvania.

NaviNet® is a registered trademark of NantHealth.





eft attestation and registration guide...2019/12/09 · registration guide december 2019...

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