E-Check Debit Instructions
Illinois Health Alliance E-Check will produce a check or electronic debit for the amount of your purchase.
The Illinois Health Alliance E-Check will be routed to your bank for payment, just like a check written from
your checkbook. Only the amount that you have specified on the E-check will be debited from your account.
Your bank will include the Illinois Health Alliance E-Check with your regular monthly statement information.
This transaction is secure and all information contained within are subject to Illinois Health Alliance privacy
- To use this E-check you must have a valid checking account with sufficient funds to cover
- Take a check out of your check register and write VOID across the front of it. (Once the check is used, do not re-use again)
- Enter the numbers from the bottom of your check, from left to right. Do not enter the bank's
symbols. Only the numbers. The first set of 9 numbers is the bank routing
number, it is always 9 digits. The second set of numbers is your check number. The third set of numbers
is your checking account number. Use the symbols as a guide.
- Click on the "Continue" button to send your payment.
To avoid duplicate charges only click one time.
- Submit your AUTHORIZATION FOR E-CHECK DEBIT form when you use this payment method for the first time.
Send this signed form with all the necessary paperwork for your first order (include original prescriptions, customs
statement and a brief medical summary).
- Write this check information into your check register for your reference.
- You will be sent a Receipt containing the details of this transaction.
- An additional processing fee of $10.00 CAN will be added every time the E-check service is used.
Conditions for E-check Debit Payments:
There will be a $35.00 USD fee or the maximum amount permitted by law for returned
checks. The check writer is also responsible for all other costs of collection.
Your usage of E-check debit for payment is your acceptance of this agreement and
Check fraud and fraud attempts will be reported to the authorities and prosecuted to the fullest
extent allowed by law.