EDI Forms
Electronic Funds Transfer
To download the EFT Authorization forms, you can visit our Website at
http://www.wpsic.com/edi/tools.shtml
. You will want to download the overview for the instructions on how to complete the form and also download the EFT Agreement - Medicare (PDF)
After you complete all sections and sign and date the form, attach a copy of a voided check, making sure the routing number and account number on your form matches the numbers on your voided check copy and mail the agreement to:
WPS Insurance Corporation
EDI Department
8120 Penn Ave., Suite 200
Bloomington, MN 55431
Page Last Updated: Monday, 09-Jun-2008 13:18:37 CDT
