Common Contracts
1 similar Electronic Remittance Advice (Era) Authorization Agreement contracts
Health Net of California Electronic Remittance Advice (ERA) Authorization AgreementElectronic Remittance Advice (Era) Authorization Agreement • January 7th, 2015
This authorization is to remain in effect until written notice in the form of an ERA Authorization Agreement form marked as a cancellation or change form is submitted to Health Net. Any changes to the providers agent, clearinghouse or vendor must be submitted on an ERA Authorization Agreement form as a change. The termination or change shall be effective 20 days subsequent to Health Net's receipt of the updated form.
