Vendor Payment Setup

Set up ACH payments from Revenue Cycle Solutions

So we can pay you by direct deposit (ACH), please provide your business and banking details and attach a W-9 and a voided check. We confirm these details with you directly before sending any payment.

Your banking details are submitted securely and are never sent by email. We will call or email a contact we already have on file to confirm this account before paying it.

1 Your Business

Legal Business Name * (as on your W-9)

DBA (if any)

Tax Classification (from your W-9)

Email for Remittance / Payment Notices *

Contact Name

Contact Phone

Contact Email

2 Bank Account for Deposit

Financial Institution *

Account Type *

Checking Savings

Routing Number * (9 digits)

Account Number *

Re-enter Account Number *

3 Documents

W-9 (PDF or image)

Voided Check or Bank Letter (PDF or image)

A voided check or a bank-issued letter helps us confirm your account details quickly.

Submitted securely to Revenue Cycle Solutions. Bank details are never sent by email.

Set up ACH payments from Revenue Cycle Solutions

Thank you — we've got it