---
sourceDocument: Australia Employee Service Management
sourceDocumentLink: https://servicenow-prod.fluidtopics.net/r/pt-BR/employee-service-management

 Release :

    - australia

ft:locale :

    - pt-BR

ft:publication_title :

    - Australia Employee Service Management

ft:clusterId :

    - emplsm

bundleId :

    - emplsm

workflow :

    - Employee


---

# Payers Enrollment form

# Payers Enrollment form {#ariaid-title1}

* Versão de lançamento: Australia
* 
* Atualizado 12 de mar. de 2026
* 
* ![](https://www.servicenow.com/docs/portal-asset/ico-clock) 1 min. de leitura

Access, review and validate the Payers Enrollment details of a healthcare professional in the Payer enrollment form.
{#hr-payer-en__table_l3d_s5j_jbc__entry__2}

| 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. |
[Tabela 1. Payers Enrollment form]

{#hr-payer-en__table_l3d_s5j_jbc}
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