Mercy Healthcare Group 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. The completed information may be returned by mail or faxed to:

Mercy Healthcare Group
Attn: Provider Services
4350 E. Cotton Center Blvd. Building D
Phoenix, AZ 85040
Fax: (602) 263-3034