Get What Number Do I Fax Completed Medicare Forms

Barring some extenuating circumstances, Medicare only accepts electronic claims, so for any rehab therapy practice that's in network with Medicare, enrollment in the EDI process is a must. And they aren't the only ones—you'd be hard-pressed to find a payer that still accepts paper claims in this day and age.

The Administrative Simplification Compliance Act (ASCA) requires that Medicare claims be sent electronically unless certain exceptions are met. Providers meeting an ASCA exception may send their claims to Medicare on a paper claim form.

Contact Details Organization Type:State Medical Assistance OfficeOrganization Description:Medicaid programCovered States and Territories:WisconsinInformation:Toll Free: (800) 362-3002 Local: (608) 266-1865 Fax: (608) 221-8815 Web Site: https://.dhs.wisconsin.gov/medicaid/index.htm Hours: 7:45am-4:30pm M-F1 more row

How to file a Medicare claim Fill out a Patient's Request for Medical Payment form. ... Get an itemized bill for your medical treatment. ... Write a letter and add supporting documents to your claim. ... File your claim for Medicare reimbursement.

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 (PDF).

You can fax your completed enrollment form to us at 1-888-858-3875.

You can complete form CMS-40B (Application for Enrollment in Medicare – Part B [Medical Insurance]) and CMS-L564 (Request for Employment Information) online. You can also fax the CMS-40B and CMS-L564 to 1-833-914-2016; or return forms by mail to your local Social Security office.

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.