• This page, EFT/ERA Enrollment, is   offered by
  • MassHealth

EFT/ERA Enrollment

Various forms and relevant instructions used by MassHealth

An electronic remittance advice, or ERA, is an explanation from a health plan to a provider about a claim payment. An ERA explains how a health plan has adjusted claim charges based on:

  • Contract agreements
  • Secondary payers
  • Benefit coverage
  • Expected copays and co-insurance

Table of Contents

Electronic Funds Transfer Enrollment/Modification Form [EFT-1]

Electronic Funds Transfer (EFT) Enrollment/Modification Form Instructions

Electronic Remittance Advice Enrollment/Modification Form [ERA-1]

835 Electronic Remittance Advice (ERA) Enrollment/Modification Form Instructions

EFT/RA Operating Rule Job Aid

Contact

Phone

TTY/TDD 711

Online

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