The table below includes the following information for each of the Medicare Part B MACs: Note: These resources are compiled annually. Depending on what type of health care costs Aetna and UnitedHealthcare are both major providers of Medicare Advantage insurance plans. If you still do not know the address of your Medicare contractor, call 1-800-MEDICARE (1-800-633-4227). Each MACs name is hyperlinked to its website where you can read more information. ClaimShuttle - JK NGS Medicare: New York Medicare eCFR :: 42 CFR Part 421 Subpart E -- Medicare Administrative Federal Register, Volume 88 Issue 81 (Thursday, April 27, 2023) The purpose of this website is the solicitation of insurance. Box 6777 Fargo, ND 58108-6777, Novitas Solution P.O. If you receive retirement benefits and Medicare through the Railroad Retirement Board, your claims are handled by a separate Medicare Administrative Contractor (MAC) regardless of which state you live in. This website is not affiliated with GoHealth Urgent Care. The purpose of this site is the solicitation of insurance and informational purposes only. LCDs exist in the absence of a national coverage policy, and they may vary from jurisdiction to jurisdiction. Make sure to check your spam folder if you don't see it. Medicare Advantage Medicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. If youve already gotten the item or service, you need to file it within 120 days of the date of the initial denial notice from the MAC that used the LCD. Mail your completed claim form to the Medicare contractor responsible for processing your claim. For example, if you live in Rhode Island, your Medicare Part A/B MAC is National Government Services, Inc., the MAC for jurisdiction K. This MAC also assists with home health and hospice claims. . Contact may be made by an insurance agent/producer or insurance company. .gov 7500 Security Boulevard, Baltimore, MD 21244. Review of Current Medicare Administrative Contractors hb```f``ra`e`f`@ G,X7r^sU`r CGS Medicare Round Table Event for Ambulance Suppliers, Providers and Health Professionals - 04.25.23 J15 Provider Contact Center (PCC) Training - May 2023 - 04.25.23 Medicare Administrative Contractors (MACs) will host a Multi-Jurisdictional CAC meeting regarding Non-Invasive Technology for Coronary Artery Plaque Analysis on Thursday . Highest customer reviews on one of the most highly-trusted product review platforms. Box 3396 Mechanicsburg, PA 17055-1841, First Coast Service Options, Inc. P.O. PDF Claim Filing Instructions So, if you have a Medicare Advantage plan through Company A, any claims you file will go to Company A and not Medicare. Currently, there are 12 Medicare Part A and B MACs that assist with Original Medicare (Medicare Parts A and B). The physician is legally authorized to practice where he or she furnished the services, Print your name as shown on your Medicare card (Last Name, First Name, Middle Name), Print your Medicare Number exactly as it is shown on the Medicare card, Check the appropriate box for the patients sex, Furnish your mailing address and include your telephone number, Describe the illness or injury for which you received treatment, Patients Condition related to: Check the appropriate boxes, The provider or suppliers National Provider Identifier(NPI) If known, The ordering & referring Providers Full Legal Name and address fire quired as indicated in Section 2. Medicare contractors are required to develop and disseminate Local . Annual Part B deductible and coinsurance amounts do not apply. 0z> !5zPd*|bOpm(h|ICs@+5NmS4%.f [QWs5+5Nm|,zK 9B . Box 6727 Fargo, ND 58108-6727, Noridian Healthcare Solutions, LLC P.O. HtA Box 3098 Mechanicsburg, PA 17055-1816, Noridian Healthcare Solutions , LLC P.O. "i $gx` IG? If you cannot sign your name, mark an (X) on the signature line. All rights reserved. NOTE: You must attach an itemized bill in order for Medicare to process this claim Medicare Administrative Contractor (MAC) Resources NOTICE: Anyone who misrepresents or falsifies essential information requested by this form may upon conviction be subject to fine and imprisonment under Federal law. Your MSN is sent out every three months and details the Medicare services youve received, and how much Medicare has agreed to pay for them. HtPA | QR(c/yovi4J*UltKw^"7p}r8 aa)lgg;zh1^F;g;Q[vhIGKrA?m}ykB,9Bm48ibh1[ g` ) U.S. Department of Health & Human Services Complete a blank sample 1997- American Speech-Language-Hearing Association. Please check your spelling or try another term. This article discusses the role that MACs play and how to find information about your coverage. Box 3397 Mechanicsburg, PA 17055-1842, Novitas Solutions P.O. Reference the Medicare Administrative Contractor Address table for the correct address to mail your claim form. If the jurisdiction website is unavailable, we've linked to the provider log-in page. information to address the patient's condition and course at the time the patient is Mailing your application to this address will significantly delay application processing, (PLEASE RETURN ONLY THE FORM AND NOT THE INSTRUCTION), National Government Services, Inc. P.O. endstream endobj 2123 0 obj <>/Subtype/Form/Type/XObject>>stream Medicare Reporting Form - Fill and Sign Printable Template Online
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