831 PAYMENT TO NHEP PROVIDERS (FAM)

____________________________________________________________

NHEP providers due to receive payments from the Department for services provided to NHEP participants have the option of:

• receiving mailed, paper checks; or

• receiving their payments via Electronic Funds Transfer (EFT) in lieu of paper checks.

*NHEP providers may only receive payments from the Department if they have enrolled with the Department. To enroll, the NHEP provider must do all of the following:

• complete *Form NHEP251, NHEP Provider Enrollment. New providers must also be provided with and complete:

- Form AW-9L, Request for W-9 Information; and

- Form AW-9, Alternate W-9 Form-CIS Payer’s Request for Taxpayer Identification Number and Certification; and

• mail the completed forms to the Data Management Unit (DMU).

When a provider’s request for payment is received by the District Office, * forward the forms to the DMU.

To change or terminate EFT, the NHEP provider must notify the DMU in writing, by providing a new Form NHEP251.