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Posting Date: 11/08/2019
Supporting Documents
Supporting Documents Attach required supporting documentation for individuals or organizations. Submit applicable documents. CMS-588 EFT Authorization Agreement and voided check or bank confirmation letter IRS document confirming your [...]
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Posting Date: 11/12/2021
Supporting Documents
Supporting Documents Attach required supporting documentation for individuals or organizations. Submit applicable documents: CMS-588 Electronic Funds Transfer (EFT) Authorization Agreement and voided check or bank confirmation letter IRS [...]
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Posting Date: 11/12/2021
Electronic Funds Transfer Agreement
Electronic Funds Transfer Agreement Download and complete the CMS-588 Electronic Funds Transfer (EFT) Authorization Agreement. Physicians and nonphysician practitioners who are reassigning all of their payments to another entity are not [...]
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Posting Date: 06/07/2021
Verify and Manage Signature(s)
Verify and Manage Signature(s) Verify signatures on all application(s) submitted including applications that were “Return for Corrections”, by returning to the enrollment box in PECOS. Important: The reassignments are viewed by selecting [...]
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