EFT Frequently Asked Questions

 


What do I need to enroll?
To enroll for Electronic Funds Transfer (EFT), you must be a current first.dba contracted Pharmacy and currently receiving the Electronic Remittance Advice (835 electronic data file).

An EFT enrollment form is available online and must be filled out completely with organization, banking, and contact information. Once completed, the form can be faxed or mailed to other.dba

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 If I enroll, when will I receive my first transfer?
Claims received after your EFT enrollment has been processed will be paid electronically. Please allow 30 days after mailing or faxing the application for the EFT enrollment process to be completed. Please note: after EFT is activated, paper checks and claims remittance advice reports will no longer be mailed to you. If you feel that you must receive an interim paper remittance after your conversion, it can be mailed to you for 31 days after your conversion, if you request it.

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 How will I know when my enrollment is effective?
A pharmacy will know that its enrollment has been completed when the electronic funds are deposited into the authorized bank account. No other notification will be sent.

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 Why do I have to receive my claims remittance advice electronically in order to enroll in EFT?
If a pharmacy chooses to receive payment by EFT, you must enroll in the Pharmacy ERA Program. The other.dba Electronic Payment System will only provide remittance advice in an electronic format. If a contracted pharmacy chooses to continue receiving paper checks, they will also continue to receive paper claims remittance advice reports. For Pharmacies that are converting to EFT for the first time, the paper remittance advice can be provided for 31 days after conversion, if requested by the Pharmacy.

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 Can I still get a hardcopy/paper remittance advice report?
Once you enroll for ERA, you will not receive hardcopy/paper remittance advice report unless you request it.  The paper remittance advice can be mailed for up to 31 days after your ERA enrollment has been processed, if you request it. All claims remittance information will be sent to you electronically using the 835 data file. If you feel that you must receive the claims remittance advice in hardcopy/paper, you may elect to continue receiving paper checks in which case a hardcopy/paper report will be sent with your check.

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 Does enrollment in EFT affect the way we submit claims?
No. You will continue to use your current process for all claims submissions.

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 If I don't currently receive my 835 electronically, how can I start?
You must complete the ERA enrollment form. other.dba will require your FTP and/or PGP key information. Once you receive the 835 electronically, you will need to provide and maintain the equipment, software, and personnel necessary to reliably receive, process, and maintain electronic documents in accordance with all applicable laws and regulations. Some pharmacy software vendors provide such software to their subscribers.

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 If my EFT is late or missing, whom do I contact?
If your EFT is late or missing, please contact OptumRx Customer Service at 800 797 9791.

The Centers for Medicare & Medicaid Services (CMS) provides free software called Medicare Remit Easy Print (MREP) that allows professional providers and suppliers to print and view the HIPAA compliant 835. For more information regarding this software, please access the CMS website at: http://www.cms.hhs.gov/.