---
title: Payers Enrollment form
description: Access, review and validate the Payers Enrollment details of a healthcare professional in the Payer enrollment form.
locale: en-US
canonical_url: https://www.servicenow.com/docs/r/australia/employee-service-management/hr-service-delivery-for-healthcare/hr-payer-en.html
release: australia
product: HR Service Delivery for Healthcare
classification: hr-service-delivery-for-healthcare
topic_type: reference
last_updated: "2026-03-12"
reading_time_minutes: 2
breadcrumb: [HR Service Delivery for Healthcare reference, HR Service Delivery for Healthcare, HR Service Delivery, Employee Service Management]
---

# Payers Enrollment form

Access, review and validate the Payers Enrollment details of a healthcare professional in the Payer enrollment form.

|Field|Description|
|-----|-----------|
|Healthcare professional profile|Profile associated to healthcare professional.|
|Payer name|Name of payer who makes payments to the healthcare provider.|
|Payer plan name|Name of payer plan.|
|Plan number|Unique plan number against which payments are made by healthcare provider.|
|Active|Option to indicate that the payer enrolment record is active.|
|Effective From|Date starting which payer enrolment is valid.|
|Effective Till|Date until which payer enrolment is valid.|

**Parent Topic:**[HR Service Delivery for Healthcare reference](https://raw.githubusercontent.com/ServiceNow/ServiceNowDocs/australia/markdown/australia/employee-service-management/hr-service-delivery-for-healthcare/reference-hr-healthcare.md)

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