Adp Direct Deposit Setup Form

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ADP DIRECT DEPOSIT SETUP FORM
ADP is pleased to present a simple solution for you to expedite your claim payments. With Direct Deposit, you can begin receiving
your claim payments within a few days after your claim is processed.
Please read the following information prior to completing the ADP Direct Deposit Form. If you have any questions, please call 1-800-678-6684.
Direct Deposit Setup
Once account information is received, ADP records, validate, and update each participant’s record with the routing number and account number.
The file is then put into a “pre-note” status for a period of 10 days. Pre-noting an account is the process of forwarding a zero payment transmission
to the account to verify the accuracy of the account information. If the transmission is not rejected within the 10-day period, the information is
considered accurate. Once the pre-note period expires, all claim payments will be issued via direct deposit.
Payment Notification
Without the use of direct deposit, checks are attached to an Explanation of Benefits (EOB) statement detailing the claim payment. With the use of
direct deposit, claim payments may or may not result in receipt of an EOB. The following details the notification process with direct deposit in place:
An EOB will not be issued. Your bank statement will reflect the deposit. You can access claim payment and balance
Total Expense Paid
information via mySHPS at or via ADP Interactive Voice Response telephone system.
An EOB is issued detailing the reason for partial payment. You can access or ADP Interactive
Partial Payment
Voice Response telephone system to review details regarding the payment.
• Full Denial – An EOB is issued detailing the reason for claim denial.
Email Notification
If you provide ADP with your email address, we will provide you with online reimbursement activity and account activity statements.
With email communications, you can receive a complete EOB statement (total expense paid, partial payment, or full denial) whenever claim
activity is processed against your account.
How to complete the Direct Deposit Setup Form
• Provide all of the personal information, including your Social Security Number, in the allocated section. To begin receiving your account
reimbursement statements via email, you must provide your email address.
• Section A must be completed for processing. Enter the banking information from your check in accordance with the example.
• Tape a copy of a voided check or deposit slip in the lower left corner. The tape should be placed on top of the check horizontally, corner to
corner.
Do Not Staple.
• Select the account type: Checking or Savings. (Check one box only.)
• For savings accounts, please note that you must verify the Transit/ABA Number and the bank account number with your bank.
• Sign the Employee Authorization section, as processing cannot begin without a signed form.
• Validate all information and mail the completed and signed ADP Direct Deposit Setup Form to the address provided.
• Email address information should be in the following format:_______(Name)@______(Location).______(Extension). Example:
EFTNETNEW
SHPS 12/08/2005

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