How to Fill Out and Submit the Humana EFT Enrollment Form

To complete the Humana EFT enrollment form, gather your Tax Identification Number, National Provider Identifier, bank routing and account numbers, and a voided check or recent bank letter, then submit either through the ERA/EFT Enrollment tool on Availity Essentials or on the paper enrollment package from Humana’s provider site. Processing takes roughly 30 days, followed by another seven days before your first electronic payment lands.¹

What the Form Asks For

Have everything on hand before you open the form. A missing or mismatched field is the most common cause of a rejected enrollment.

Tax Identification Number. The nine-digit federal TIN for your practice or organization. The name on your bank account must match the legal name tied to this TIN. A mismatch will get the enrollment kicked back.
National Provider Identifier. Your 10-digit NPI. Humana pays at the NPI level, so if your organization uses more than one NPI and you want each routed to a different bank account, you file a separate enrollment for each.¹
Bank routing and account numbers. The nine-digit ABA routing number and the checking or savings account number. Verify both against a recent statement; a transposed digit will cause the pre-note verification to fail.
Voided check or bank letter. One of the two must be attached. If you use a bank letter, it has to be on the bank’s letterhead, show the account holder’s full legal name, and be signed and dated within the past 12 months.¹
Two recent Humana payments. If you enroll through Availity, the portal asks for two recent check or EFT payment references from your organization so it can verify you.²

One structural limit worth knowing up front: all payments for a given NPI go to a single bank account. There is no way to split deposits under one NPI across multiple accounts. If a particular location needs its own account, that location needs its own NPI and its own enrollment form.¹

Clear These Blockers First

Two prior arrangements will conflict with a new enrollment if you do not undo them first.

If Humana is currently paying you through its Virtual Credit Card program, call ECHO Health at 888-483-9212 to opt out of VCC before you submit the EFT form. If you previously set up EFT through CAQH rather than directly with Humana, log into CAQH and cancel that arrangement; otherwise your Availity submission will collide with the existing setup.²

Filling Out the Form on Availity Essentials

Availity is Humana’s preferred channel and the faster route. Once logged into Availity Essentials:

Open the Payer Spaces tab and click the Humana icon.
Under Applications, select ERA/EFT Enrollment. If the option is not visible, your organization’s Availity administrator has to grant access.³
If Humana has not verified your organization before, the system will ask for two recent Humana payment references.²
Choose Start for a new enrollment. (Change and Cancel are for existing ones.)
Read and accept the Humana EFT terms and conditions.
Enter submitter and contact details, and choose whether payments should aggregate by TIN or by NPI.
Pick your ERA delivery method. If you use a clearinghouse, select it from the list the system provides.
Enter your bank routing number and account number.
Click Submit. Save the Request ID on the confirmation page; you need it to check status later.²

Watch one field in particular. On the Contact Information step, the “Relationship with this provider organization” dropdown lets you move on without picking a value. Leaving it blank triggers an automatic rejection.⁴

Submitting the Paper Form Instead

If you would rather not use Availity, download the EFT and ERA Enrollment Package from Humana’s provider site. The paper form collects the same information as the online version: TIN, NPI, bank routing and account numbers, account type, and an authorized signature certifying that the data is accurate and that you agree to accept electronic payments. Attach the voided check or bank letter to the completed form.¹

The enrollment package does not list a publicly verified fax number or mailing address on the form. Check the submission instructions on the current version you download, or call Humana provider services to confirm where to send it.

What Happens After You Submit

Humana takes about 30 days to receive and process the enrollment, with another seven days after processing clears before electronic payments actually begin.¹ Payments continue in whatever form they arrived before, usually paper checks or virtual credit card notifications, during that gap.

Part of verification is a pre-note. Humana sends a small test entry to the bank account to confirm the routing and account numbers are valid and can receive ACH credits. Watch your bank statements for it. When it lands, confirm receipt in Availity: on the Provider Details page, select Confirm Pre-note from the Request Type dropdown, choose the relevant record, and enter the date the pre-note appeared in your account.⁵

Do not enter a date if the pre-note has not actually arrived. A false confirmation delays activation instead of speeding it. If the pre-note never shows up, ask your bank to verify the account can accept ACH credits, then call Humana provider services.

Electronic Remittance Advice Comes With It

EFT enrollment automatically enrolls you for Electronic Remittance Advice. The ERA replaces the paper Explanation of Remittance and delivers the same detail electronically as a HIPAA-compliant 835 file, either through Availity Essentials or through the clearinghouse you selected during enrollment.³ The deposit itself carries a trace number that matches the 835, so your practice management software can pair each deposit with its remittance automatically.⁶

Changing or Canceling Later

To update your bank account information, go back into the ERA/EFT Enrollment tool on Availity, choose Change rather than Start, and walk through the same screens with your new bank details. To end enrollment entirely, choose Cancel from the same tool.³

Expect a processing window comparable to the original enrollment before a change takes effect. Keep the old bank account open until you have confirmed payments are arriving in the new one; closing it early risks a deposit stranded between accounts. For anything involving Virtual Credit Card routing specifically, call ECHO Health at 888-483-9212, Monday through Friday, 8 a.m. to 6 p.m. Eastern.³

1
Humana Military. Electronic Funds Transfer and Electronic Remittance Advice Enrollment Package
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Availity. Humana EFT Enrollment Form
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Humana. Electronic Claims Payment For Providers
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Availity. Humana ERA/EFT Enrollment Auto Reject
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Availity. Availity Enrollment Form Payer ID 61101
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CMS. Health Care Payment and Remittance Advice and Electronic Funds Transfer