Medicare_Carriers_Manual / 3002 / 3002

Why This Topic Matters

Understanding the forms and referenced filing guidance helps readers identify which Medicare claims documents are discussed and where related instructions can be found in the manual system.

Article Sections

1. Ed. Note: For further information see

   References to related manual chapters and guidance on claims filing and participation status are listed here.

2. 3002. Claims Forms

   This section introduces the claims forms used for Medicare Part B services and discusses the administrative framework surrounding their use and reproduction.

3. A. General

   Background is provided on the historical use of Medicare Part B claims forms and their transition within the manual context.

4. B. Form CMS-1500 (Health Insurance Claim Form)

   This subsection identifies the CMS-1500 as the prescribed form for certain Medicare claims and points to completion instructions elsewhere in the manual.

5. C. Form CMS-1490 (Patient’s Request for Medicare Payment)

   This subsection describes beneficiary-filed claim handling and references related documentation and filing circumstances.

6. D. Form CMS-1491 (Request for Medicare Payment-Ambulance)

   This subsection addresses the ambulance claim form and related submission handling for ambulance suppliers.

7. E. Form CMS-1490U

   This subsection covers the indirect payment provision and the organizational claim form used under that process.

8. F. Form CMS-1556 (Prepayment Plan for Group Practices Dealing Through A Carrier)

   This subsection discusses a group practice prepayment plan form and its place in the Medicare carrier billing framework.