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Office to receive an 835/ERA ONLY (this form is NOT for EFT or EFT enrollment). For assistance with registration for the EFT/ERA please contact PaySpan at 877-331-7154 and select option one. All fields on the form must be filled in, in order for your 835/ERA set up to be completed. Enrollment does take between 5-10 business days for completion. Once your enrollment is completed we will notify your clearinghouse and the Provider s Authorized Agent. For question and or status regarding this for.

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