Medicare Part B Home Care Billing: A Comprehensive Guide

Medicare is a federally funded and operated health insurance program consisting of two main parts: Part A (inpatient hospital) insurance and Part B (outpatient medical) insurance. If your home care provider does not accept Medicare assignment, but the services provided are eligible for Medicare Part B payments, you can submit a claim directly to Medicare and receive reimbursement for a portion of the claim. If you are unsure whether a home health provider accepts Medicare assignment, you may contact the home health provider directly or contact Medicare at 1-800-MEDICARE.

Instructions

• 1

  Contact your medical provider and request that the provider file a Medicare claim, even if they do not accept Medicare assignment. If they do not file a Medicare claim, proceed to Step 2.

• 2

  Contact 1-800-MEDICARE to verify the time frame that you have between time of service and time of claim filing. This varies between 15 months to 27 months depending on the service.

• 3

  Gather necessary information for completing claim forms. You will need the claim number from your health insurance card, name, address, illness or injury that required treatment and a copy of the medical bill.

• 4

  Complete form CMS 1490S, available from the Centers for Medicare and Medicaid Services website. Attach requested supporting documentation, such as a copy of the medical bill or any requested medical records, and submit the form to the location listed on the form.