Register for Electronic Funds Transfer
Mercy Care Plan offers electronic funds payment directly to your bank account. If
you would be interested in this option, please click
here
to access the Electronic Funds Transfer (EFT) Authorization Form. Complete the top
portion in its entirety and return it along with a voided check or preprinted deposit
slip for verification of your bank account number. Completed information may be
returned by mail or faxed to:
Mercy Care Plan
Attn: Provider Services
4350 E. Cotton Center Blvd. Bldg D
Phoenix, Arizona 85040
Fax: (602) 263-3034