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:

  1. Select the Step 10: Add Payment Details hyperlink.

The System displays the Payment Details page.

  1. Enter the required (*) information for the Financial Institution Information you need to add.

  2. Select the Address button.

The System displays the Address details page.

  1. Enter the appropriate address in the Address Line 1 field.

  2. Enter the appropriate Zip Code.

  3. Select the Validate Address button.

The System auto-populates the remaining fields with the appropriate information.

  1. 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.

  1. Select the OK button.

  2. The System saves the Payment Details and displays the Payment Details List page.

  3. Select the Close button.

The System displays the Enroll Provider – Individual page.

Related Topics

Individual