EFT Form
Please provide the following information to enroll in Electronic Funds Transfer.
New York Members and Providers: Our plan name will soon be changing to Trinity Health Plan New York. You may start to see this name on our website and in upcoming plan communications.
Ohio Members and Providers: Your website has moved! Please visit www.thpmedicare.org/mount-carmel for your plan information.
Please provide the following information to enroll in Electronic Funds Transfer.