EFT Authorization: Direct Billing Members

If you are a group plan member set up for direct billing, use this secure form to sign up to pay your policy premiums through electronic funds transfer (EFT) or to update your EFT information. EFT enrollments and changes may take up to 3 business days to process.

Note: Individual plan payments will not be accepted through this form. If you are an individual plan member needing to set up or update EFT, sign into the member portal. 

Important Information

When are EFT payments pulled from my account?
Your bank will transfer the funds to Delta Dental of Arizona on the first Friday following or coinciding with the 5th of the month.

Can I submit a paper EFT authorization instead of the online form?
Of course. You can download the EFT Authorization for Direct Billing Members and send the completed form back to us. Submission information is on the form.

Questions?

Hours:
Monday - Thursday: 7:30 A.M. - 5 P.M.
Friday: 7:30 A.M. - 4:30 P.M.

Toll-free Phone:
800.352.6132