Apply for Tebra Payments

Access Application

1. Hover over the User icon and click on Practice Settings. The Practice Settings page opens.
2. Click Tebra Payments. The Tebra Payments page opens.
3. Click Apply Now at the bottom of the page. The Welcome to Tebra Payments pop-up window opens.
   • If the application was saved as a draft, click Continue Application to complete the application.
4. Click Let's Get Started. The application opens.

Complete Application

The application has six sections: Business Information, Bank Information, Products & Services, Ownership Information, Attachments, and Review & Sign.

Note: The required information (e.g., subsections, questions, etc.) to complete the application will vary depending on the Ownership Type selected in the Business Information section. The example ownership type used for this article is LLC.

Bank Information

1. Business Information: Enter all information. 
   1. Bank Name: The account's bank institution name.
   2. Account Owner/Business Name: The name on the bank account.
      Note: Only business bank accounts are accepted, unless the business is a sole proprietorship.
   3. Account Type: Click to select Checking or Savings.
   4. Account Number: Enter the bank account number and enter it again to confirm.
   5. Routing Number: Enter the bank routing number and enter it again to confirm.
2. Click Next. The Products & Services page opens.
   • To save the application as a draft to complete at a later time, click Save For Later. System Administrators have 60 days to complete and submit the application. The draft application can be accessed from the Tebra Payments page under Practice Settings.

Products & Services

1. Practice Finances: Enter the information.
   1. Expected Average Transaction Amount: The average amount the practice charges per transaction.
   2. Expected Highest Transaction Amount: The maximum amount the practice charges for one transaction.
   3. Expected Average Monthly Processing Amount: The average amount the practice makes per month.
2. Products/Services: Enter the information.
   1. Description of Products and/or Services: The description of the business, including any specialty services provided.
   2. Click to select Yes or No to indicate if the practice prescribes Marijuana, CBD, and/or Nutraceuticals.
   3. Click to select Yes or No if the practice offers telehealth.
      • If yes, the Telehealth Information section displays. Enter the information then proceed to step 3.
      • If no, proceed to step 3.
3. Click Next. The Ownership Information page opens.
   • To save the application as a draft to complete at a later time, click Save For Later. System Administrators have 60 days to complete and submit the application. The draft application can be accessed from the Tebra Payments page under Practice Settings.

Ownership Information

1. Primary Owner: Enter the information.
   1. First and Last Name: The primary owner's full legal name, not a nickname.
   2. Date of Birth: Enter the date or click the calendar icon to select a date.
   3. SSN: The primary owner's SSN, not the business EIN/TIN.
      Note: The primary owner's SSN is still required even if the EIN/TIN was entered under the Business Information section.
   4. Ownership Percentage: The percentage of ownership that the owner has of the business.
2. Primary Owner's Contact Information: Enter the information.
   1. Phone Number: The contact phone number for the primary owner.
   2. Email: A valid email address for the primary owner and ensure it is a reliable email account that is checked often.
      Note: This email address will be used for legal documentation and can be the same email address as the Business Email.
3. Primary Owner's Address: Enter the primary owner's residential Address Line 1, Address Line 2 (if applicable), City, State, Country (automatically populates with U.S.), and Postal Code.
4. If there are additional owners that have more than 25% ownership, click + Add Owner and enter the information.
   • To add additional owners, click + Add Owner and enter the information.
   • To remove an owner, click Remove Owner.
5. Click Next. The Attachments page opens.
   • To save the application as a draft to complete at a later time, click Save For Later. System Administrators have 60 days to complete and submit the application. The draft application can be accessed from the Tebra Payments page under Practice Settings.

Attachments

1. Attach the appropriate documents.
   Note: The supported file types are PDF, JPG, JPEG, and PNG.
   • Void Check or Bank Letter (Required): Click Attach to upload a voided check or bank letter that includes the bank name, account owner, account number, and ACH routing number.
     Note: Direct Deposit Forms, Bank Account Summaries, Counter/Starter Checks, and Deposit Slips are not accepted.
   • TIN Document: If the business has been established for less than a year, click Attach to upload a government issued proof of business taxpayer identification number (TIN) (e.g., CP-575, LTR-147C, SS-4).
   • Medical Practice's Licenses/Certifications/Accreditations: Click Attach to upload the document(s).
   • Practitioner's Credentialing: Click Attach to upload the document(s).
   • Notice of Privacy Practices and HIPAA: Click Attach to upload the document(s).
2. Click Next. The Review & Sign page opens.
   • To save the application as a draft to complete at a later time, click Save For Later. System Administrators have 60 days to complete and submit the application. The draft application can be accessed from the Tebra Payments page under Practice Settings.

Review & Sign

1. Review the information under each section of the application.
   • To make corrections to a section of the application, click Edit.
   • To expand or collapse a section, click the arrow.