URGENT MESSAGE TO ALL PROVIDERS WHO RECEIVE MEDICARE PAYMENTS VIA ELECTRONIC FUNDS TRANSFER (EFT)

Tennessee Medicare Part B providers accustomed to receiving Medicare payments via Electronic File Transfer (EFT), who have not submitted a new CMS-588 form to Cahaba GBA, MUST submit a CMS-588/EFT form (http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf), Authorization Agreement for Electronic Funds Transfer, IMMEDIATELY.

PROVIDERS THAT HAVE NOT SUBMITTED THE CMS-588 EFT FORM WILL NOT RECEIVE MEDICARE PAYMENTS UNTIL THE NEW CMS-588 IS RECEIVED BY CAHABA GBA. IF YOU HAVE ALREADY SUBMITTED THE EFT FORM, PLEASE DO NOT SEND IN ANOTHER ONE. AS LONG AS YOU HAVE SENT IT TO THE APPROPRIATE CAHABA ADDRESS OR FAX BELOW, WE HAVE YOUR FORM.

To ensure we receive your CMS-588/EFT form quickly, please fax to (912) 921-4993 or (912) 927-6946 and mail the hardcopy original to one of the addresses referenced below.

Cahaba GBA, LLC
Provider Enrollment TN Part B
P O Box 830170
Birmingham, AL 35283-0170

Overnight:
Cahaba GBA, LLC
Provider Enrollment TN Part B
300 Corporate Parkway
Birmingham, AL 35242

EFT Resources:

• Form CMS-588: http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf


• EFT Instructions: http://www.cms.hhs.gov/ElectronicBillingEDITrans/13_EFT.asp


• Tips On Completing the CMS-588: http://www.cahabagba.com/j10/CMS588_tips.pdf

Thank you,
Provider Enrollment(PE)
Cahaba GBA- J10 A/B MAC