Get EFT Enrollment Agreement - Blue Cross Blue Shield Of Illinois
Electronic Funds Transfer EFT Authorization Agreement This EFT Authorization Agreement must be fully completed signed and returned via U.S. Mail or fax to Blue Cross and Blue Shield of Illinois BCBSIL Electronic Commerce Services 300 E. Randolph St. 6th Floor Chicago Illinois 60601 Fax 312-946-3500 A voided check from the provider s account or a letter from the financial institution on financial institution letterhead specifying the provider s na....
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