Add Payment Details
Use this link to add the enrolling Provider’s payment details, specifically where to receive funds for approved services.
Note: You must complete all previous steps before you can complete the following procedure.
To add Payment Details:
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Select the Step 10: Add Payment Details hyperlink.
The System displays the Payment Details page.
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Enter the required (*) information for the Financial Institution Information you need to add.
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Select the Address button.
The System displays the Address details page.
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Enter the appropriate address in the Address Line 1 field.
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Enter the appropriate Zip Code.
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Select the Validate Address button.
The System auto-populates the remaining fields with the appropriate information.
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Confirm that the auto-populated information is correct and select the OK button.
The System saves the Address Details and displays the Payment Details page.
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Select the OK button.
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The System saves the Payment Details and displays the Payment Details List page.
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Select the Close button.
The System displays the Enroll Provider – Individual page.