All Part A MAC Part A Policy Part A Fees Part A Training Part A Departments Part A Publications Part A Self Service Part A FAQ Part A Forms
		Search Tips

 

Create/Update eNews Account

| Web Tutorial

 

 

Electronic Funds Transfer Information

EFT Changes & Requirements

In accordance with the Program Integrity Manual, Section 10.4 (Rev. 41, 05-23-03), CMS now views a change to the EFT form (Form CMS-588) as a change to the pay to" address. Any time an enrolled provider notifies WPS s financial department that they are changing bank accounts for their EFT, the provider enrollment area will check to see if there is a competed provider enrollment form (Form CMS-855A) on file.

If the enrolled provider does have a completed provider enrollment form (Form CMS-855A) on file, WPS will verify that the signature on the newly submitted EFT form (Form CMS-588) matches the signature on the provider enrollment form (Form CMS-855A).

If the enrolled provider does not have a completed provider enrollment form (Form CMS 855A) on file with WPS - Provider Enrollment Area, they must complete an entire Form CMS-855A. The signature on the EFT form (Form CMS-588) must match the signature on the provider enrollment form (Form CMS-855A).

The address to send the completed Form CMS-855A to:

WPS
Provider Enrollment
PO Box 8310
Omaha, NE 68108-0310

 

 

Page Last Updated: Friday, 06-Nov-2009 14:04:41 CST