
When appropriate, paper claims should be mailed to: J15 — Part B Claims CGS Administrators, LLC PO Box 20019 Nashville, TN 37202 NOTE: Part B claims, including Medicare Secondary Payer (MSP) claims, are accepted and processed as electronic claims through myCGS, our secure web portal.
Can I submit a paper claim to Medicare?
Medicare is prohibited from payment of claims submitted on a paper claim form that do not meet the limited exception criteria. CMS has provided a listing of exceptions to electronic claim submission on its Administrative Simplification Compliance Act Self-Assessment Web page. Some of these include:
Where do I Send my Medicare claim to?
The address to send the claim to can be found on the Medicare website or on your Medicare Summary Notice Who normally files a claim? Typically, your Medicare claims should be sent directly from your provider to Medicare. Your provider will then be paid a reimbursement rate according to the program’s regulations and legislation.
How do I enroll in Medicare Part B?
Please visit our Medicare Part B webpage if: You are already enrolled in Medicare Part A. You would like to enroll in Part B during the Special Enrollment Period. You can complete form CMS-40B ( Application for Enrollment in Medicare – Part B [Medical Insurance]) and CMS-L564 (Request for Employment Information) online.
How to sign up for Medicare Part B if you lost coverage?
You lost job-based health coverage within the last 8 months. To sign up for Part B using a Special Enrollment Period, you’ll also need to fill out and submit an Application for Enrollment in Part B (CMS-40B) form at the same time.

Where do I send my CMS 40B?
Send your completed and signed application to your local Social Security office. If you sign up in a SEP, include the CMS-L564 with your Part B application. If you have questions, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
Can I mail my Medicare application?
You can apply online or you can mail your completed CMS 40B, Application for Enrollment in Medicare - Part B (Medical Insurance) to your local Social Security office.
Where do I mail form CMS-L564?
All Employers: If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, MD 21244-1850.
Where do I send the CMS 1763 form?
Where should Form CMS-1763 be sent? The CMS 1763 form must be completed during or after an interview with a representative from the Social Security Administration. Having filled it out completely, the applicant should submit it to the applicant's local SSA office.
How do you enroll in Medicare Part B?
Contact Social Security to sign up for Part B:Fill out Form CMS-40B (Application for Enrollment in Medicare Part B). ... Call 1-800-772-1213. ... Contact your local Social Security office.If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
How long does it take for Medicare Part B to be approved?
You can also call the Social Security Administration at 1-800-772-1213 or go to your local Social Security office. It takes about 45 to 90 days to receive your acceptance letter after submitting your Medicare application.
How do I submit CMS L564?
You should submit your Form CMS-L564 and Form CMS-40B together at the same time. You may deliver the forms to your local Social Security office by mail or in person. Important note: if you do not already have Medicare Part A, you shouldn't complete the CMS-40B form.
What is an L564?
Form CMS-L564 is an employment information form from the Social Security Administration (SSA). It's used in conjunction with Form CMS-40B when you apply for Medicare part B during a special enrollment period (SEP). One portion is completed by you and the other is completed by your employer or your spouse's employer.
What is form OMB No 0938 0787 for?
This information is needed to determine whether an individual is eligible to enroll in Medicare Part B or Premium Part A under the provisions of section 1837(i) of the Social Security Act (The Act) and/or qualify for a reduction in the premium amount under the provisions of section 1839(b) of the Act.
How do I file a CMS 1763?
How to Complete Form CMS 1763?Write down the name of the enrollee. ... State your Medicare number;Choose the type of coverage you want to terminate. ... Indicate the date when your hospital or medical insurance coverage should end;State the reasons for the termination. ... Make sure the request is complete and sign the form.More items...
Do you have to take Medicare Part B?
Medicare Part B isn't a legal requirement, and you don't need it in some situations. In general, if you're eligible for Medicare and have creditable coverage, you can postpone Part B penalty-free. Creditable coverage includes the insurance provided to you or your spouse through work.
What form do I use to opt out of Medicare Part B?
CMS-1763To disenroll, you're required to submit a form (CMS-1763) that must be completed either during a personal interview at a Social Security office or on the phone with a Social Security representative. For an interview, call the Social Security Administration at 1-800-772-1213, or your local office.
What happens if you don't sign up for Part B?
If you don’t sign up for Part B during your IEP, you can sign up during the GEP. The GEP runs from January 1 through March 31 of each year. If you sign up during a GEP, your Part B coverage begins July 1 of that year. You may have to pay a late enrollment penalty if you sign up during the GEP. The cost of your Part B premium will go up 10% for each 12-month period that you could have had Part B but didn’tsign up. You may have to pay this late enrollment penalty aslong as you have Part B coverage.
How long do you have to be a SEP?
You have a SEP if you were volunteering outside of the United States for at least 12 months for a tax-exempt organization and had health insurance (through the organization) that provided coverage for the duration of the volunteer service.
When should I file a Medicare claim for myself?
Medicare claims are expected to be filed within 12 months of the original date of service.
Why do you need a letter from Medicare?
Reasons for filing your own claim that you may want to put into the letter include your provider not filing the claim in a timely manner, the provider or supplier does not participate in Medicare, ...
What to do if your medical provider does not accept Medicare?
If a claim has not been filed in a timely manner by your medical provider, you should first contact them and then you can file a claim yourself if the time limit is running out. You may able to file a claim for reimbursement if you received care from a provider that did not accept Medicare. The form you need to use to file your claims is available ...
What to do if you don't file a claim with Medicare?
If you find that your claims are not being filed within the appropriate timeline, the first thing to do is contact your provider, whether it be a doctor or medical supplier, and request that they file the claim. If they still do not file the claim, your next step would be to contact Medicare directly. If the time limit is coming to ...
When did Medicare stop accepting claims electronically?
The Administrative Simplification Compliance Act (ASCA) requires that as of October 16, 2003, all initial Medicare claims be submitted electronically, except in limited situations. Medicare is prohibited from payment of claims submitted on a paper claim form that do not meet the limited exception criteria.
Do you have to file a claim with Medicare?
Note: Generally, Medicare beneficiary's don't need to file Medicare claims. For services provided by home health and hospice providers, the provider must file the claim for you. For additional resources for Medicare patients, refer to the People with Medicare web page.
