Medicare Claims address-When and How to file for reimbursement

If you have original Medicare then you never need to file a Medicare claim except in few rare cases which we are going to discuss later. Because according to the law, requires Medicare providers and suppliers to file Medicare claims for the covered services they render to the beneficiary or Members.

If you are enrolled in Medicare Advantage Plan i.e. Part C, then you need to find out managed care plan by checking eligibility and file claims directly to them to get paid. Because Medicare Insurance pays these private insurance companies a set amount each month.

 

When to File a Claim for reimbursement?

As we informed initially only in very rare cases patient has to file a Medicare claim if:

  • Doctor or Supplier won’t file a claim or Refuses to file a claim.
  • Provider or Supplier not enrolled in Medicare.

Medicare claims must be filed no later than 12 months from the date you receive the health care services.  So check your Medicare summary Notice issued every 3 months from Medicare, if you get any services from provider or suppliers to make sure claims are being filed timely.

If suppose provider or supplier didn’t file a Medicare claim, the first thing you have to do is contact them and ask them to file a claim. In most cases they will resolve the issue if you bring them to their attention.

You should file the claim, if provider or supplier still hasn’t file the claim and it’s close to the end of the time limit. Call Medicare number at 1-800-633-4227 for more assistance.

 

How to file a claim for Medicare reimbursement?

Fill out the Patient’s request for Medical payment form and follow the instructions for the type of claim you are filing.

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms1490s-english.pdf

  • PART B Services

Below is the address you need to return the completed claim form, itemized bill, supporting documentation and letter explaining in detail for the reason you are submitting the claim:

StatePlease send the completed form to the below Medicare Claims address
AlabamaPalmetto GBA

Medicare Part B Claims

P.O. Box 100306

Columbia, SC 29202-3306

AlaskaNoridian Healthcare Solutions

P.O. Box 6703

Fargo, ND 58108-6703

American SamoaNoridian Healthcare Solutions

P.O. Box 6777

Fargo, ND 58108-6777

ArizonaNoridian Healthcare Solutions

P.O. Box 6704

Fargo, ND 58108-6704

ArkansasNovitas Solutions

P.O. Box 3098

Mechanicsburg, PA 17055-1816

California (Northern)Noridian Healthcare Solutions

P.O. Box 6774

Fargo, ND 58108-6774

California (Southern)Noridian Healthcare Solutions

P.O. Box 6775

Fargo, ND 58108-6775

ColoradoNovitas Solutions

P.O. Box 3107

Mechanicsburg, PA 17055-1823

ConnecticutNational Government Services, Inc.

P.O. Box 6178

Indianapolis, IN 46206-6178

DelawareNovitas Solutions

P.O. Box 3397

Mechanicsburg, PA 17055-1842

District of Columbia (Washington, DC)Novitas Solutions

P.O. Box 3396

Mechanicsburg, PA 17055-1841

FloridaFirst Coast Service Options, Inc.

P.O. Box 2525

Jacksonville, FL 32231-0019

GeorgiaPalmetto GBA

Medicare Part B Claims

P.O. Box 100306

Columbia, SC 29202-3306

GuamNoridian Healthcare Solutions

P.O. Box 6777

Fargo, ND 58108-6777

HawaiiNoridian Healthcare Solutions

P.O. Box 6777

Fargo, ND 58108-6777

IdahoNoridian Healthcare Solutions

P.O. Box 6701

Fargo, ND 58108-6701

IllinoisNational Government Services, Inc.

P.O. Box 6475

Indianapolis, IN 46206-6475

IndianaWisconsin Physicians Service

P.O. Box 8940

Madison, WI 53708-8940

IowaWisconsin Physicians Service

P.O. Box 8550

Madison, WI 53708-8550

KansasWisconsin Physicians Service

P.O. Box 7238

Madison, WI 53707-7238

KentuckyCGS Administrators, LLC

P.O. Box 20019

Nashville, TN 37202

LouisianaNovitas Solutions

P.O. Box 3097

Mechanicsburg, PA 17055-1815

MaineNational Government Services, Inc.

P.O. Box 6178

Indianapolis, IN 46206-6178

MarylandNovitas Solutions

P.O. Box 3398

Mechanicsburg, PA 17055-1843

MassachusettsNational Government Services, Inc.

P.O. Box 6178

Indianapolis, IN 46206-6178

MichiganWisconsin Physicians Service

P.O. Box 8987

Madison, WI 53708-8987

MinnesotaNational Government Services, Inc.

P.O. Box 6475

Indianapolis, IN 46206-6475

MississippiNovitas Solutions

P.O. Box 3129

Mechanicsburg, PA 17055-1834

MissouriWisconsin Physicians Service

P.O. Box 14260

Madison, WI 53708-0260

MontanaNoridian Healthcare Solutions

P.O. Box 6735

Fargo, ND 58108-6735

NebraskaWisconsin Physicians Service

P.O. Box 8667

Madison, WI 53708-8667

NevadaNoridian Healthcare Solutions

P.O. Box 6776

Fargo, ND 58108-6776

New HampshireNational Government Services, Inc.

P.O. Box 6178

Indianapolis, IN 46206-6178

New JerseyNovitas Solutions

P.O. Box 3030

Mechanicsburg, PA 17055-1802

New MexicoNovitas Solutions

P.O. Box 3107

Mechanicsburg, PA 17055-1823

New YorkNational Government Services, Inc.

P.O. Box 6178

Indianapolis, IN 46206-6178

North CarolinaPalmetto GBA – J11 MAC

Mail Code: AG-600

P.O. Box 100190

Columbia, SC 29202-3190

North DakotaNoridian Healthcare Solutions

P.O. Box 6706

Fargo, ND 58108-6706

Northern Mariana IslandsNoridian Healthcare Solutions

P.O. Box 6777

Fargo, ND 58108-6777

OhioCGS Administrators, LLC

P.O. Box 20019

Nashville, TN 37202

OklahomaNovitas Solutions

P.O. Box 3107

Mechanicsburg, PA 17055-1823

OregonNoridian Healthcare Solutions

P.O. Box 6702

Fargo, ND 58108-6702

PennsylvaniaNovitas Solutions

P.O. Box 3418

Mechanicsburg, PA 17055-1854

Puerto RicoFirst Coast Service Options, Inc.

P.O. Box 45036

Jacksonville, FL 32231-5036

Rhode IslandNational Government Services, Inc.

P.O. Box 6178

Indianapolis, IN 46206-6178

South CarolinaPalmetto GBA – J11 MAC

Mail Code: AG-600

P.O. Box 100190

Columbia, SC 29202-3190

South DakotaNoridian Healthcare Solutions

P.O. Box 6707

Fargo, ND 58108-6707

TennesseePalmetto GBA

Medicare Part B Claims

P.O. Box 100306

Columbia, SC 29202-3306

TexasNovitas Solutions

P.O. Box 3108

Mechanicsburg, PA 17055-1824

UtahNoridian Healthcare Solutions

P.O. Box 6725

Fargo, ND 58108-6725

VermontNational Government Services, Inc.

P.O. Box 6178

Indianapolis, IN 46206-6178

Virginia (Arlington and Fairfax Counties, including city of Alexandria)Novitas Solutions

P.O. Box 3396

Mechanicsburg, PA 17055-1841

Virginia (The rest of the state.)Palmetto GBA – J11 MAC

Mail Code: AG-600

P.O. Box 100190

Columbia, SC 29202-3190

Virgin IslandsFirst Coast Service Options, Inc.

P.O. Box 45098

Jacksonville, FL 32231-5098

WashingtonNoridian Healthcare Solutions

P.O. Box 6700

Fargo, ND 58108-6700

West VirginiaPalmetto GBA – J11 MAC

Mail Code: AG-600

P.O. Box 100190

Columbia, SC 29202-3190

WisconsinNational Government Services, Inc.

P.O. Box 6475

Indianapolis, IN 46206-6475

WyomingNoridian Healthcare Solutions

P.O. Box 6708

Fargo, ND 58108-6708

 

  • DME-Durable Medical Equipment

Please find the below address to file DME services claims

StateReturn your Completed form to below Medicare Claims address:
Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, VermontNoridian Healthcare Solutions P.O. Box 6780 Fargo, ND 58108-6780
Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, WisconsinCGS Administrators, LLC P.O. Box 20013 Nashville, TN 37202
Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, West VirginiaCGS Administrators, LLC P.O. Box 20010 Nashville, TN 37202-0010
Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, WyomingNoridian Healthcare Solutions P.O. Box 6727 Fargo, ND 58108-6727

 

  • Medical Services you got aboard a ship use these instructions

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1490S-ENGLISH-Instructions-Shipboard.pdf

 

  • Claims for services you got in Canada or Mexico

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1490S-ENGLISH-Instructions-Canada-Mexico.pdf

 

  • Claims for services you got in a foreign hospital

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1490S-ENGLISH-Instructions-Foreigntravel.pdf

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