Electronic Funds Transfer (EFT) Information: Process and Contacts

If your organization prefers to receive Medicare payments via Electronic Funds Transfer, complete Form CMS-588 and include it with your provider enrollment application. The form must be submitted with an original signature (no faxes or photocopies) of an authorized or delegated official, identified on the Form CMS-855A. In a letter, signed by the authorized or delegated official, list the signers of the bank account and explain their relationship to your organization. Please specify whether or not the signers are associates of a billing agency.

Visit the CMS' Website for the newly revised CMS Form 588 (revised September 2006) .

View all of the CMS Forms on CMS' Website.

For questions regarding this process, please contact our Medicare Financial Area using our toll free number (866) 734-1522.

Page Last Updated: Thursday, 18-Feb-2010 11:41:44 CST