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  • Eft Enrollment Form - Geisinger Health Plan

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Electronic Funds Transfer Enrollment Form Please complete form in its entirety and fax to (570) 214-1553 Provider Information: (1 form for each provider identification number) Provider Name (Group):.

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866-488-6653, Monday – Friday, 8 a.m. – 5 p.m.

The initial submission of any claim must be received by GHP within 4 months of the date of service for outpatient claims and/or 4 months of the date of discharge for inpatient claims, as applicable.

If you have questions regarding your Geisinger billing statement, contact the Patient Service Call Center at 800-640-4206 during our normal business hours and one of our staff will assist you.

Geisinger Health Plan offers quality, comprehensive coverage for all eligible Medical Assistance recipients. Each year, more than 500,000 members throughout Pennsylvania choose GHP Family for our high-quality Medicaid plan.

Call 800-447-4000 and say, “claims” to connect with a dedicated claims resolution representative.

Please use GHP's payer ID number (75273) when submitting claims via AllScripts, Emdeon, or Relay Health.

With Electronic Funds Transfer (EFT), Medicare can send payments directly to a provider's financial institution whether claims are filed electronically or on paper. All Medicare providers may apply for EFT.

You can also contact Geisinger Gold for help at: 800-498-9731, Monday – Friday, 8 a.m. – 8 p.m.

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© Copyright 1997-2025
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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
Content Takedown 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:
+1 833 426 79 33
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