PROVIDER REGISTRATION FOR ELECTRONIC FUNDS TRANSFER PAYMENTS

This form must be completed by each provider who has not claimed electronically for Medicare before. The form is used to apply for online claiming.

If the provider has claimed online previously they will not need to complete this form. 

BANKING DETAILS ONLINE CLAIMING 

This form must be completed per provider and per location. The form is used to provide your banking details for each location.

Completing this form per provider and per location is a necessity and must be processed by Medicare for Online Claiming to be successful. 

The first field on this form requires the Location ID. This number is generated in Clinic to Cloud and can be found by going to Settings >> Locations >> Selecting edit icon >> Medicare Settings. 

Forms must be sent directly to Medicare for Processing.