Medicare of California Northern – J1 P.O. Box 1051 Augusta, GA 30903-1051 Medicare of California Southern – J1 P.O. Box 1051 Augusta, GA 30903-1051 Usually Medicare does not accept primary paper claim so please find out the payor id and submit the claims electronically.
| Correspondence | USPS |
|---|---|
| Medical Review (Including Requested Post Pay Claims) | Noridian JE Part B Attn: Medical Review PO Box 6783 Fargo ND 58108-6783 |
| PWK (paperwork) | Noridian JE Part B Attn: PWK PO Box 6783 Fargo ND 58108-6783 |
| Refunds | Noridian JE Part B Attn: Refunds PO Box 511381 Los Angeles CA 90051-7936 |
Where do I get the forms to file Medicare claims?
The itemized bill must contain the following information:
- Date of service
- Place of service
- The charge for each service
- Description of your illness or injury
- Description of the medical and surgical supplies
- The name and address of the doctor or supplier
- The doctor or supplier’s National Provider Identifier Number, if you know it.
How to file your claims with Medicare?
- The date of your treatment
- Where you received treatment (hospital, doctor’s office, etc.)
- Description of each treatment or medical supply received
- Itemized charge (s) for each treatment or medical supply
How do you file a Medicare claim?
- Proof of Representation documentation.
- Proof of any items and/or services that are not related to the case, if applicable.
- All settlement documentation if you are providing proof of any items and/or services not related to the case.
- Procurement costs and fees paid by the beneficiary.
What is the address to mail Medicare claim forms?
When you claim for someone who’s on your Medicare card, you can claim in one of these ways:
- at the doctor’s office
- online
- by mail
- at a service centre.
What address do you send Medicare claims to?
Medicare All state claim address and phone number list, if any modification please comment it....Medicare claim address, phone numbers, payor id – revised list.StateArizonaIVR #1-877-908-8431Claim mailing addressMedicare Part B P.O. Box 6704 Fargo, ND 58108-6704Appeal addressMedicare Part B PO Box 6704 Fargo, ND 58108-6704Online resourcewww.noridianmedicare.com22 more columns
Can you mail in Medicare claims?
4. Mail completed form and supporting documents to Medicare All claims must be submitted by mail; you can't file a Medicare claim online. You can find the mailing address for your state's contractor in a number of ways: View the second page of the Medicare instructions for your Medicare claim type.
How do I submit a claim to Medicare?
Contact your doctor or supplier, and ask them to file a claim. If they don't file a claim, call us at 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048. Ask for the exact time limit for filing a Medicare claim for the service or supply you got.
What form is used to send claims to Medicare?
Form CMS-1500Providers sending professional and supplier claims to Medicare on paper must use Form CMS-1500 in a valid version. This form is maintained by the National Uniform Claim Committee (NUCC), an industry organization in which CMS participates.
Does Medicare accept secondary paper claims?
Currently, Medicare does not accept electronically filed claims when there is more than one payer primary to Medicare. Claims that involve more than one primary payer to Medicare must be submitted on the 1500 paper claim form, with all appropriate attachments.
Where do I send my Medicare form CMS 1490s?
MEDICARE ADMINISTRATIVE CONTRACTOR ADDRESS TABLEIf you received a service in:Mail your claim form, itemized bill, and supporting documents to::California Southern (For Part B)Noridian Healthcare Solutions, LLC P.O. Box 6775 Fargo, ND 58108-677554 more rows
Where do I fax Medicare claims?
Complete all fields and fax to 877- 439-5479 or mail the form to the applicable address/number provided at the bottom of the page. Complete ONE (1) Medicare Fax / Mail Cover Sheet for each electronic claim for which documentation is being submitted. This form should not be submitted prior to filing the claim.
What is the first step in submitting Medicare claims?
The first thing you'll need to do when filing your claim is to fill out the Patient's Request for Medical Payment form. ... The next step in filing your own claim is to get an itemized bill for your medical treatment.More items...•
How do I submit a claim to CMS 1500?
CMS does not supply the form to providers for claim submission. In order to purchase claim forms, you should contact the U.S. Government Printing Office at 1-866-512-1800, local printing companies in your area, and/or office supply stores.
What is the difference between UB 04 and CMS-1500?
The UB-04 (CMS-1450) form is the claim form for institutional facilities such as hospitals or outpatient facilities. This would include things like surgery, radiology, laboratory, or other facility services. The HCFA-1500 form (CMS-1500) is used to submit charges covered under Medicare Part B.
Does Medicare accept paper claims?
Claims may be filed to electronically (this applies to most Medicare providers) or on paper (if certain conditions or exceptions exist).
What goes in box 11 on a CMS-1500?
If the member has a secondary insurance these boxes must be completed. If YES is checked in Box 11d, enter the month, day and year the policyholder was born. The format for a birth date must be MMDDYYYY.
What is the Claims Mailing Address for Medicare?
There is no central address that all Medicare claims are sent to. Each state works with a company called a Medicare Administrative Contractor (MAC)...
How Do I File a Claim?
If you’re submitting a claim for reimbursement, you’ll need to print off a Patient Request for Medical Payment form (CMS-1490S). You can fill it ou...
Why would I need to file a claim?
As we mentioned, you may not need to file a claim if you’re on Medicare. Most of your claims will be filed for you if you’re on Original Medicare,...
What do I need to include when mailing a reimbursement claim?
Along with the completed Patient Request for Medical Payment form, you’ll also need to include:
Can I Submit a Claim Directly to Medicare If I Have Medicare Advantage?
No — if you have Medicare Advantage, all coverage decisions are made by the private insurer you purchased your policy from. So, if you have a Medic...
What is the Railroad Medicare claims address?
If you receive retirement benefits and Medicare through the Railroad Retirement Board, your claims are handled by a separate Medicare Administrativ...
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 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 ...
File a complaint (grievance)
Find out how to file a complaint (also called a "grievance") if you have a concern about the quality of care or other services you get from a Medicare provider. Contact your State Health Insurance Assistance Program (SHIP) for local, personalized Medicare counseling.
File a claim
Get information on how and when to file a claim for your Medicare bills (sometimes called "Medicare billing"). You should only need to file a claim in very rare cases.
Check the status of a claim
Check your claim status with your secure Medicare account, your Medicare Summary Notice (MSN), your Explanation of Benefits (EOB), Medicare's Blue Button, or contact your plan.
File an appeal
How to appeal a coverage or payment decision made by Medicare, your health plan, drug plan or Medicare Medical Savings Account (MSA) Plan.
Your right to a fast appeal
Learn how to get a fast appeal for Medicare-covered services you get that are about to stop.
Authorization to Disclose Personal Health Information
Access a form so that someone who helps you with your Medicare can get information on your behalf.
How to file a claim with Medicare?
Follow these steps: Fill out the claim form provided by your insurance company (if required). Attach copies of the bills you are submitting for payment (if required). Attach copies of the MSN related to those bills.
How does Medicare receive claims?
Your Medigap (supplemental insurance) company or retiree plan receives claims for your services 1 of 3 ways: Directly from Medicare through electronic claims processing. This is done online. Directly from your provider, if he/she accepts Medicare assignment. This is done online, by fax or through the mail.
How much does Medicare pay for Part B?
If the provider accepts assignment (agrees to accept Medicare’s approved amount as full reimbursement), Medicare pays the Part B claim directly to him/her for 80% of the approved amount. You are responsible for the remaining 20% (this is your coinsurance ). If the provider does not accept assignment, he/she is required to submit your claim ...
Does Medicare send a bill for MSN?
For more information, see Assignment for Original Fee-for-Service Medicare . Medicare will send you a Medicare Summary Notice (MSN) form each quarter. Previously known as the Explanation of Medicare Benefits, the MSN is not a bill. You should not send money to Medicare after receiving an MSN.
Phone
For specific billing questions and questions about your claims, medical records, or expenses, log into your secure Medicare account, or call us at 1-800-MEDICARE.
1-800-MEDICARE (1-800-633-4227)
For specific billing questions and questions about your claims, medical records, or expenses, log into your secure Medicare account, or call us at 1-800-MEDICARE.
What happens when a medical foundation appears on a subscriber's identification card?
When the name of a medical foundation appears on a subscriber's identification card, the benefits for that subscriber are administered by that foundation. Forward all claims to that foundation for payment. Listed below, by county, are the addresses of medical foundations with which Blue Shield is affiliated.
How long does it take for a claim to be capitated for Blue Shield?
Claims for capitated services provided to a Blue Shield HMO member that are erroneously sent to Blue Shield for processing/payment will be forwarded to the appropriate capitated provider within 10 working days of the receipt.
Mailing Addresses
Certain types of correspondence requires different levels of separation to assist our office in getting provider's documentation and requests to the appropriate team.
State Specific Exceptions
Certain types of correspondence requires different levels of separation to assist our office in getting provider's documentation and requests to the appropriate team.
When Do I Need to File A Claim?
How Do I File A Claim?
- Fill out the claim form, called the Patient Request for Medical Payment form (CMS-1490S) [PDF, 52KB). You can also fill out the CMS-1490S claim form in Spanish.
What Do I Submit with The Claim?
- Follow the instructions for the type of claim you're filing (listed above under "How do I file a claim?"). Generally, you’ll need to submit these items: 1. The completed claim form (Patient Request for Medical Payment form (CMS-1490S) [PDF, 52KB]) 2. The itemized bill from your doctor, supplier, or other health care provider 3. A letter explaining in detail your reason for subm…
Where Do I Send The Claim?
- The address for where to send your claim can be found in 2 places: 1. On the second page of the instructions for the type of claim you’re filing (listed above under "How do I file a claim?"). 2. On your "Medicare Summary Notice" (MSN). You can also log into your Medicare accountto sign up to get your MSNs electronically and view or download them an...