Electronic Funds Transfer (EFT)

Electronic Funds Transfer (EFT) deposits your Medicare payments directly into your bank account. CMS requires that all providers enrolling, revalidating, or making any changes to their file must use EFT.

Sign Up

Complete an Electronic Funds Transfer Authorization Agreement - CMS 588. To assist in correctly completing the application, view the Enrollment on Demand Application Tutorials.

  • Authorized/delegated official must sign and date form; signature must be original (cannot be a copy or stamped signature)
  • If authorizing payments to Chain Home Office, be sure to attach letter authorizing Noridian to make payments due to provider service to account maintained by Chain Home Office and have it signed by Authorized or Delegated Official of provider and Chain Home Office Authorized Official
  • Include a copy of a voided check or bank letter stating legal business name. Include a letter of verification from your financial institution. Letter must be on bank letterhead and signed by a bank official and must also include verification of the following: type of account (checking or savings), name on account, account number and ACH routing number

Make Account Changes

To change accounts or banks, complete a new 588 form, using the new account information, by following the Enrollment on Demand Application Tutorials.

  • Complete form and return it with an original signature of authorized/delegated official for that organization
  • Include a voided check or letter of verification from your financial institution. Letter must be on bank letterhead, signed by a bank official and must include verification of following: type of account (checking or savings), name on account, account number and ACH routing number
  • In Account Holder Information section, indicate your Medicare (Noridian) Part B PTAN in Medicare Identification Number field
  • If submitting a Change of Ownership, check that option in Part I
  • If authorizing payments to Chain Home Office, be sure to attach letter authorizing Noridian to make payments due to provider service to account maintained by Chain Home Office and have it signed by Authorized or Delegated Official of provider and Chain Home Office Authorized Official

 

Last Updated Feb 26 , 2020