Electronic Funds Transfer transaction

Electronic Funds Transfer Transaction Provider Requirements

Electronic Funds Transfer transaction is the required method of Medicare payment for all providers entering the Medicare program for the first time and for existing providers that are submitting a change to their existing enrollment data but are not currently receiving payments via Electronic Funds Transfer transaction.

Once a provider begins to receive Medicare payments via EFT, the A/B MAC or DME MAC shall not issue any routine, ongoing payments to the provider via check.

For purposes of this instruction, the term “routine, ongoing payments” means those payments that are not considered to be “special payments,” as that latter term is used in section 4 of the CMS-855 application

This means, therefore, that – with the exception of special payments – a provider that receives payments via EFT must continue to receive payments via EFT transaction and cannot switch back to receiving paper checks, even in cases of a MAC transition or other CMS-initiated action. A/B MACs and DME MACs shall not approve any requests to change the provider’s payment method from EFT transaction to check.

Note that the A/B MAC or DME MAC shall abide by the instructions on all provider enrollment issues relating to Electronic Funds Transfer. This includes the requirement that A/B MACs and DME MACs compare the information and signature on the provider’s Form-CMS-588 (Electronic Funds Transfer Authorization Agreement), to that on the provider’s CMS-855 form on file. For changes of information, DME MACs shall verify the authorized official on the CMS 855.

An A/B MAC or DME MAC shall use a transmission format that is both economical and compatible with the servicing bank. If the money is traveling separately from an ASC X12 835 remittance advice transaction, then A/B MACs and DME MACs shall use National Automated Clearinghouse Association (NACHA) format CCP (Cash Concentration/Disbursement plus Addenda -CCD+) to make sure that the addenda record is sent with the EFT. Providers need the addenda record to re-associate dollars with data. A/B MACs and DME MACs shall transmit the EFT authorization to the originating bank upon the expiration of the payment floor applicable to the claim. They shall designate a payment date (the date on which funds are deposited in the provider’s account) of two business days later than the date of transmission.

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