Search results with tag "Request for medical payment"

1490-Patient's Request for Medical Payment

If a physician or supplier furnishes Medicare covered services to you and refuses to submit a claim on your behalf for those services, please call 1-800-MEDICARE (1-800-633-4227) in order to file a complaint with the Medicare contractor. TTY users should call 1-877-486-2048. When you submit your own claim to Medicare, complete the entire form.

  Form, Medical, Medicare, Payments, Request, Request for medical payment