Do I have to submit an authorization agreement for electronic funds transfer (CMS 588) to the NPWest?


Answer:
DMEPOS suppliers are required to submit the EFT agreement with the application form when initially enrolling or submitting an application for a new location. Suppliers are also required to submit the EFT agreement during revalidation, reactivation or changing information if not already enrolled to receive electronic payments.

Also, suppliers should submit any updates to exisitng EFT information to the NPWest for processing.

When completing the form, suppliers should ensure the form has the signature of the authorized or delegated official. Further, suppliers must include with each form a voided check or confirmation of account information on bank letterhead for verification of the account number.

The CMS 588 (PDF) form may be downloaded from the CMS website.



Last Updated: 06/13/2024