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Auxilary Aids & Services

For information about the availability of beneficiary auxiliary aids and services, please call our Beneficiary Contact Center at 800-833-4455.

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Railroad Medicare Beneficiaries
How and When to File a Claim for Medicare Payment

As a Medicare beneficiary, you should rarely need to file a claim for services or supplies that Medicare covers. By law, doctors and suppliers are required to file claims for Medicare covered services. 

One situation that you may need to file is when your provider or supplier has not submitted a claim and it is getting close to the time limit for filing a Medicare claim. The time limit for filing a claim to Medicare is 12 months from the date of service. If your claim is getting old and you find Medicare has not received a claim, you should first contact your provider and ask them to file a claim. Then, if they do not submit a claim for you, you should  submit a claim yourself.          

There are two 'Patient’s Request for Medicare Payment' forms that you can use to file a claim. With either claim, you must attach an itemized bill from the provider or supplier. You must also include a detailed explanation of why you are submitting the claim. Examples include a statement that explains your provider/supplier is not enrolled with Medicare, is unable to file a claim, or refuses to file a claim. If you are filing a claim for non-covered services in order to receive a denial to submit to another insurance, please explain that you are billing for a denial. 

The first form is called the RRM G-740S (03-13) form. This form is used by Railroad Medicare beneficiaries to file a claim for Part B services to the Railroad Medicare contractor. The form is set up with the correct format of a Railroad Medicare Health Insurance (HICN) number and is prefilled with the Palmetto GBA Railroad Medicare Part B claims address. The form can be found on our website under Resources or by clicking on the link below. Instructions for completing the form are found on the second page of the form.

The second form is the CMS-1490S Patient's Request for Medicare Payment form. This form is used by all Medicare beneficiaries and can be used to file claims for Part B and Durable Medical Equipment (DME) claims. The form with instructions is found on the CMS website. If you are filing a claim for a durable medical supply, choose the link for the  CMS 1490S-English Instructions-DME or Spanish Instructions-DME. The instructions include the correct address to send your claim to. The form can be found on the CMS website by clicking the link below.       

If you have questions about filing a Medicare claim, you can call our toll-free Customer Service Line at 800-833-4455, Monday through Friday, from 8:30 a.m. until 7:00 p.m. ET. For the hearing impaired, call TTY/TDD at 877-566-3572. This line is for the hearing impaired with the appropriate dial-up service and is available during the same hours Customer Service Representatives are available.

 

last updated on 07/01/2015
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