EFT Authorization: Individual & Direct Billing Members

Use this secure form to sign up to pay your policy premiums through electronic funds transfer (EFT) or to update your EFT information. Note: EFT enrollments and changes may take up to 3 business days to process.

Important Information

When are EFT payments pulled from my account?
Your bank will transfer the funds to Delta Dental of Arizona around the 5th of each month.

Can I submit a paper EFT authorization instead of the online form?
Of course. You can download the EFT Authorization for Individual & 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