Financial Area - 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: Thursday, 13-Nov-2008 10:06:44 CST
