Get Bcbs Direct Deposit Authorization For Hcra & Dcra Payments. Bluerx Physician Drug Authorization

Completing the BCBS Direct Deposit Authorization form is a straightforward process that enables you to receive your HCRA and DCRA payments directly to your bank account. This guide provides clear steps to assist you in filling out the form accurately and efficiently.

Follow the steps to successfully complete your authorization form.

1. Press the ‘Get Form’ button to access the authorization form and open it in your chosen editor.
2. Carefully read the instructions provided on the form to understand the requirements for completion.
3. Fill in the 'Subscriber Name' field with your full name as it appears on your insurance policy.
4. Enter your 'Contract Number(s)' in the specified field, ensuring accuracy for proper identification.
5. Provide your 'Day Time Phone Number' so that the Blue Cross and Blue Shield of Alabama can contact you if needed.
6. Select the type of account for direct deposit: 'Checking Account' or 'Savings Account' by filling in the appropriate circle.
7. Specify the name of your bank in the 'Depository (Bank) Name' field.
8. Input your 'ABA Routing #' which can be found on your bank checks or by contacting your bank.
9. Provide your 'Account Number' where the funds should be deposited.
10. Attach a canceled or voided check that corresponds with your specified account to verify information.
11. Sign and date the form at the designated area to authorize the agreement.
12. Return the completed form along with the attached check by mail to the address provided or fax it to the Treasury Operations.

Complete your authorization form online today to ensure timely payments directly to your bank account.