Aging Parents and You: Tips for Getting Reimbursed When Doctors Don’t Take Medicare–the Form. Part 2

NOTE–November 2015–Awaiting Update that may negate the Part B Medicare coverage–although information about secondary insurance remains valid, I believe.

Filling Out The “Patient’s Request for Medical Payment Form”

Your doctor doesn’t “take” Medicare. He or she has opted out. You have Medicare Part B coverage. You’ve paid your bill. You should have been given a copy of the bill along with a copy of your doctor’s letter, signed and dated, this includes date of service as well as the date your doctor declined Medicare participation. Now it’s time to file for your reimbursement. My understanding is that one can file up to a year after the date after the medical service–ie. 7/7/14-7/7/15. But why wait so long?

The following gives the best chance to succeed on the first try. Also remember if you have secondary coverage, Medicare will forward the necessary information to them when you check that box.

1. Fill out every applicable section of Medicare’s Patient’s Request for Medical Payment form CMS-1490S, using the preceding highlighted link or one downloaded form the last post.

2. “Send the Completed Form To” (located top right on form). Here is information for mailing your claim form  CMS-1490S. Click this link for your state’s address. The addresses begin on page 2, following an introductory letter.

3. Mail each claim in a separate envelope.
–Include CMS-1490-S form, its accompanying doctor’s opt-out letter and bill. You might be inclined to put several claims and supportive documents in the same envelope, but the person I spoke with said 1 claim form (CMS 1490S), 1 doctor’s opt-out letter and 1 bill in 1 envelope is the most foolproof. (If your inclination is to do otherwise–suggestion: call Medicare and ask their guidance).

4. Keep a copy of each-filled-out 1490S form, along with bill and doctor’s letter that you send.

I get the feeling that claims are looked at by many. Whether scanned or passed around, keeping it as simple as possible for those reviewing your claim is the way to go.

*                 *               *

Note: If phoning Medicare, I was also told: To reduce the wait- time after the initial hopefully not-too-long wait– at the first opportunity–press any numbered option given. It may not be the department you want, but they’ll get you to the proper place quicker. (Haven’t tried this yet.)

Related: What Medicare Part B Covers(It covers more than doctors) from Medicare’s website

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

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