Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Authorization Agreement Instructions
The EFT/ERA authorization web form and notification emails are currently offline for maintenance; Optima Health is currently processing these requests manually. To request EFT/ERA, or to make changes to your existing account, please follow the instructions below that are most relevant to your needs. We appreciate your patience.
New EFT/ERA Setup
- Complete in its entirety the EFT/ERA Authorization Agreement PDF form.
- Obtain a letter from your bank on the bank’s letterhead, including the physical bank address, account number, routing number, the bank employee’s name, title, email, and phone number of the person who has signed the letter. The letter must not be dated more than 90 days prior.
- Form must be signed by the provider or an authorized representative of the provider.
- Submit all documents by email to EFT_ERA_Inquiry@sentara.com or fax to 757-252-8037.
- Optima Health will validate the provider’s relationship with the banking institution.
- Tax ID information will be validated in the payment system.
- Once the process is complete, the EFT information will be input into the payment system and the Provider will be notified that the set-up has been completed.
Bank Account Changes
- Complete in its entirety the EFT/ERA Authorization Agreement PDF form.
- Include the current banking institution name, routing number and last 4 digits of the account on file with Optima Health.
- Submit all documents by email to EFT_ERA_Inquiry@sentara.com or fax to 757-252-8037.
- Validation of all information will be completed before changes will be made.
- When necessary, the EFT ERA Inquiry team will contact the provider representative on record for validation.
- Banking information will not be changed in the payment system until validation is completed.
- Once the process is complete, the Provider will be notified of the set-up.