Last Modified: 5/10/2018 Location: FL, PR, USVI Business: Part A, Part B
Information you need to know about the CMS-588: ‘Electronic Funds Transfer (EFT) Authorization Agreement’
The Centers for Medicare & Medicaid Services (CMS) has specified that effective January 1, 2014, all electronic funds transfer (EFT) forms submitted must be the CMS-588 version 09/13 .
In addition, the Code of Federal Regulations Title 42: Public Health Part 424.510(9)(e)(1)(2) states that all providers and suppliers must:
• Agree to receive Medicare payment via EFT at the time of enrollment, revalidation, or change of Medicare contractors where the provider or supplier was already receiving payments via EFT or submission of an enrollment change request
• Submit the CMS-588 form to receive Medicare payment via EFT
What this means to providers:
• A new provider must submit a completed CMS-588 form (i.e., "Electronic Funds Transfer (EFT) Authorization Agreement") with his or her initial enrollment application.
• An established provider who does not currently receive EFT payments but wishes to make changes to an existing enrollment record must submit a completed CMS-588 form with his or her enrollment application.
• An established provider who does currently receive EFT payments but wishes to make changes to his or her banking information must submit a completed CMS-588 form, indicating the revisions, as well as any required documentation to support the requested changes.
Note: Providers must notify First Coast Service Options Inc. (First Coast) regarding any changes to payment information including:
• Changes in the provider’s payment address
• Changes in the bank account number
• Changes in the bank routing number
• Bank mergers or bank acquisitions (e.g., one bank is acquired by another)
• Changes in the bank name
Do Not Forward (DNF) process
CMS requires all Medicare administrative contractors (MACs) to place a provider who fails to notify that contractor of any changes to EFT information on a Do Not Forward (DNF) status (if electronic funds are returned). The DNF process may occur when a provider is aware of changes to their payment information (e.g., new payment address, changes to bank information) but fails to notify First Coast.
First Coast must follow CMS’ instructions specified in internet-only manual (IOM) Publication 100-04, Chapter 1, Section 80.5 . Returned paper checks, remittance notices, or EFT payments shall be flagged as DNF if returned from the post office or banking institution, respectively, as this may indicate that the provider’s special payment address (Section 4 of the CMS-855) or EFT information has changed.
The provider should submit CMS-855 and CMS-588 forms to update to the appropriate information. If the provider does not have an established enrollment record in Provider Enrollment, Chain and Ownership System (PECOS), he or she must complete the CMS-855 application and the CMS-588 EFT form.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.