How to manually file a claim with Medicare

In the rare occasion that your doctor does not file a claim for you with Medicare, don’t worry! you can actually file the claim yourself and it is pretty easy.

You will need to follow the instructions on this document and make sure you provide as much supporting documentation as possible including:

  • A copy of the bill
  • Your Medicare information
  • The doctor’s NPN (call the doctor who treated you and ask them for it)

http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1490S-ENGLISH.pdf

The process is pretty straight forward and a decision is usually provided within 30 days.

Please send the completed claim form, your itemized bill, and any supporting documents
to the appropriate Medicare contractor and explain in detail your reason for submitting
the claim. For example, include a statement that notifies the Medicare contractor that
your provider or supplier refused or is unable to file a claim for a Medicare-covered
service and/or is not enrolled with Medicare.

For people who live in Missouri, this is the mailing address to send claims to:

Wisconsin Physicians Service
Medicare Claims
P.O. Box 14260
Madison, WI 53708-0260

Good luck!