Minnesota Direct Deposit Form 1 - Free Download
4.3,
3578
votes
Please vote for this template if it helps you.
DIRECT DEPOSIT OF MEDICAID PAYMENTS: Electronic Funds Transfer (EFT)
State vendors are now required to submit banking information to the State pursuant to Minnesota Statutes,
section 16A.40:
The commissioner may require payees to supply their bank routing information to enable the
payments to be made through an electronic fund transfer.
How it will work:
• Direct deposit payment will be generated by Federal Employer Identification Number (FEIN) and will combine the
payment of all providers who share the same FEIN. Some businesses may need to make changes to their internal
accounting systems in order to correctly identify all enrolled providers billing under the same FEIN. You will
continue to receive a Remittance Advice (RA) as you have in the past. The RA will be generated by provider
number and will be sent to the address designated on the application form.
• Payment is made directly into your bank account(s). Bank routing will allow payments to multiple banks and/or
accounts. Payments made via direct deposit are received, on average, within two business days of disbursement.
This means you will no longer have to wait for a check through the US Mail for your payment. The date your
payment will be available to you is determined by your bank, but once established, should always be the same.
• Each FEIN is assigned a vendor number, which will appear on the upper right-hand corner of the Remittance
Advice.
• The Eligibility Verification System (EVS) is available to track payment. It will tell you if payment was
electronically transferred, the date and payment amount. Additionally, after you are set up for direct deposit, you
will receive a PIN number from Minnesota Management and Budget to access their website, for more detailed
payment information.
• The transition process from paper to direct deposit may take up to 90 days to complete. In the interim, you will
receive a paper warrant (check).
To start the process:
Read the following Direct Deposit Instructions, complete the Direct Deposit Authorization Form(s), and return to the
address at the bottom of the instruction page. Additionally, if you have multiple accounts, complete a separate
authorization form for each account and attach a list of the NPIs/UMPIs of the providers whose payments are to be
deposited into the account.
After the authorization form is received and you are set up for direct deposit, a vendor number will be assigned to each
FEIN. Minnesota Management and Budget will notify you of the vendor number, PIN (for accessing the website) and
the effective date of the electronic payment.
IMPORTANT: You may already receive direct deposit payments from state agencies other than the
Department of Human Services. However, a separate authorization is required for direct deposit of your
Medicaid payments, and the authorization form must be submitted to the Department of Human Services.
If you have any questions regarding this process, contact the Provider Enrollment Section at 651-431-2700 or
1-800-366-5411.
