Medicare Eft Agreement Form

April 10, 2021 5:13 pm Published by

The Centers for Medicare – Medicaid Services (CMS) requires all providers to submit a CMS-588 (EFT) electronic money transfer form to receive payments electronically. Once suppliers are registered with EFT, the EFT agreement cannot be terminated and suppliers cannot request paper checks. Suppliers can register with EFT and, if necessary, update or change banking information via form CMS-588. Suppliers can also submit the form electronically via a web application via PECOS. For more information on electronic filing through PECOS, visit our website for electronic supplier registration. The information on form CMS-588 must match the information related to the current CMS-855 registration application that WPS GHA has filed. CMS-855 registration information may be obtained from PECOS. You can access the CMS-588 EFT form on the CMS website: CMS-588 EFT Form. To avoid delays in processing your application, please note that if you submit your CMS-588 EFT form without applying for CMS-855 registration, use one of the transmission options below. Support documentation to be provided with form DRE CMS-588: Instructions are provided on page 1 of form DEEP-588.

In addition, you`ll find helpful tips for completing the cmS-588 Electronic Funds Transfer (EFT) Authorization Agreement Form.

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