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  • Care Improvement Plus Eft For Providers Form

Get Care Improvement Plus Eft For Providers Form

Once this EFT form is processed by Care Improvement Plus your payments will be deducted from your account on or between the 5th 7th of each month. EFT Agreement I hereby authorize Care Improvement Plus to initiate funds transfers to pay my monthly plan premium from my bank account indicated below and authorize my bank to honor these transfers. In addition your payments are taken care of even if you re out of town. Choosing the EFT Plan Premium P.

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Payer Name: Careplus Health Plan.

Payer Name: The Mutual Group.

Note: The CarePlus Health Plans payer ID for Availity is 95092.

Payer Name: Health First Health Plans.

Claim Submissions Please submit claims for processing in a HIPAA-compliant 837 file format and file them electronically with Availity (link opens in new window) using CarePlus payer ID 95092 (specific to Availity).

Payer Name: Right Care from Scott & White.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232