831 PAYMENT TO NHEP PROVIDERS SR 07-26, 11/17 (FAM-A)

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

• receiving mailed, paper checks; or

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

To initiate a payment via EFT, the provider must do all of the following:

• complete Form EFT-V/P, Information Required to Process Electronic Funds Transfer (EFT)-Vendor/Provider, if a new provider (or New HEIGHTS-generated AE0006, if an existing provider), and Form AW-9, Alternate W-9 Form-CIS Payer’s Request for Taxpayer Identification Number and Certification; and

• mail the completed forms back to the Department.

When a provider’s request for payment is received by the District Office:

• process the request; and

• forward the forms to the Data Management Unit (DMU).

To change or terminate EFT, the NHEP provider must notify the District Office in writing.