Get Cms 1490s 2018-2025

Filling out the CMS 1490S, or Patient’s Request for Medical Payment, can seem daunting. However, this guide will provide you with clear and supportive instructions to help you complete the form accurately and efficiently online.

Follow the steps to fill out the CMS 1490S online with ease.

1. Press the ‘Get Form’ button to obtain the CMS 1490S and open it in your editor.
2. Review the instructions provided with the form before starting to fill it out to ensure you understand all requirements.
3. Begin by entering the patient information in Section 1: Include the patient's name, Medicare number, date of birth, gender, address, and telephone number.
4. Move to Section 2 to enter information about the services furnished. Provide a description of the illness or injury that prompted the treatment and attach an itemized bill containing all required details.
5. If necessary, complete Section 3 regarding health insurance coverage other than Medicare. Indicate whether the patient or their spouse is covered by another health plan and provide the insurance details.
6. Proceed to Section 4 to sign the form. The patient must declare that the information is accurate and authorize the release of their medical information.
7. After reviewing the completed form, make sure to attach all supporting documentation such as itemized bills and, if applicable, the primary insurer’s Explanation of Benefits.
8. Save your changes and consider downloading or printing a copy of the completed CMS 1490S for your records before submitting it.
9. Finally, submit the completed form along with the supporting documents to the designated Medicare Administrative Contractor.

Start completing your CMS 1490S online today and ensure your medical payment request is processed smoothly!