Get Magellan Eft Help Document - Magellan Medicaid Administration

Filling out the Magellan EFT Help Document online is a straightforward process that ensures efficient electronic funds transfers for users. This guide provides clear instructions to help you navigate each section of the document, ensuring accuracy and completeness.

Follow the steps to complete your Magellan EFT Help Document online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Select the EFT option that applies to your request from the specified dropdown menu.
3. Enter the client program by listing the client name associated with the request, such as MI, NH, or TDS.
4. Fill in the provider name accurately to ensure identification.
5. Provide the provider's address, including street name and city.
6. Select the state from the dropdown list that corresponds to the provider’s address.
7. Enter the zip code or postal code for the provider's location.
8. Input the Tax Identification Number (TIN) or Employer Identification Number (EIN) as applicable.
9. Enter the National Provider Identifier (NPI) for the provider.
10. Provide the contact name for any follow-up related to this request.
11. Enter the contact's telephone number, using no dashes or spaces (for example, 8888888888).
12. If applicable, include the telephone extension for the contact.
13. Input the email address for future communications.
14. Provide the fax number with no dashes or spaces (for example, 8888888888).
15. Enter the name of the financial institution where funds will be deposited.
16. Fill in the financial institution's address, specifying street and city.
17. Select the state from the dropdown list for the financial institution's location.
18. Enter the zip code or postal code of the financial institution.
19. Input the routing number of the financial institution.
20. Select the account type (checking or savings) relevant to the financial institution account.
21. Enter the account number designated for the funds transfer.
22. Choose the provider identifier linkage preference by selecting either TIN or NPI.
23. Select the appropriate reason for submission from the provided options.
24. Input the name of the person submitting the form to ensure proper tracking.
25. Indicate the title of the person submitting the form.
26. Verify that all information entered is accurate and correct before proceeding.
27. Finally, click on 'Submit' to complete your application. Note: Once submitted, you will receive a reference number. Please save this number for future reference should you need to track the status of your request.

Take the necessary steps to complete your Magellan EFT Help Document online today.