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WebCigna Life and Health Insurance Co First Choice Health Network 91131 Southeastern Indiana Health Organization (SIHO) 77153 ... You may also enroll for ERA (835), but you must submit your EFT enrollment first. Step 6: Complete each section of the EFT Enrollment form. ... signature as well as have you select the ERA effective date WebJun 9, 2024 · HEALTH CHOICE ELECTRONIC FUNDS TRANSFER (EFT) thAttn: Health Choice Information Systems, 410 N. 44 Street, Suite 900, Phoenix, AZ 85008 Or Fax: … shop paul mitchell
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