CMS Fingerprint Collection and Submission ProcessIn accordance with the Affordable Care Act (ACA) and implementing regulations, the Centers for Medicare and Medicaid Services (CMS) must conduct a fingerprint based background check on all individuals with a 5 percent or greater ownership interest in a provider or supplier that falls under the high risk category for purposes of enrollment screening. Accurate Biometrics has been contracted by CMS as the Fingerprint Based Background Check (FBBC) Contractor. The following instructions will guide you through the fingerprint collection and submission procedure. If, at any time during this process you have a question, please call our customer service center at 1-866-361-9944 for assistance.
IMPORTANT NOTE: Please follow these instructions only if you have received a letter in the mail by your MAC (Medicare Administrative Contractor) provider. The letter will confirm that your case has been initiated within our database, and that will allow us to process your fingerprint submission. When a case is initiated in the database, we can verify if the applicant's case information has been entered correctly by CMS or if we need to edit information. Database information must match the data on the applicant's fingerprint cards or we cannot process your fingerprints.
Step 1: Get Fingerprinted
  • Print the standard fingerprint form (FD-258) and Affidavit on regular printer paper by clicking the button below:
  • Fingerprints should be placed on the FD-258 fingerprint card.
  • Individuals may NOT fingerprint themselves; fingerprints MUST be obtained from a law enforcement agency or fingerprint vendor.
  • Each fingerprint form FD-258 must include rolled impressions of all 10 fingerprints and impressions of all 10 fingerprints taken simultaneously. (these are sometimes referred to as plain or flat impressions)
  • Affidavit must be completed by the local law enforcement agency or fingerprint vendor.
  • Contact your local law enforcement agency or fingerprint vendor to make arrangements to have your affidavit completed and hard copy ink fingerprints taken directly on each of these forms (photocopies of your fingerprints are not permitted; however, if the agency taking the prints uses livescan and a printer to print a fingerprint card, that method is acceptable). Please note that the agency may charge a fee to take your fingerprints.
  • To search for a suggested fingerprint collection site, click the button below:
Step 2: Mail the Required ItemsPayment not required
  • One original, complete Fingerprint Consent Form.
  • One original, complete Fingerprint card: FD-258 (see step 1). We prefer to receive cards that are not folded.
  • One original, complete Affidavit of Person Collecting Fingerprints
  • Mail To: Accurate Biometrics CMS Processing 500 Park Blvd Suite 1260 Itasca, IL 60143