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Medicare Form 1490-S

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Christy:
does anyone have experience with Medicare form 1490-S?  It's https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1490S-ENGLISH.pdf

the patient fills it out to request Medicare benefits. I have heard this form can be useful for specialties like acupuncture, where Medicare won't issue a denial to forward to a 2ndry payer that does cover the service.

It seems like the patient fills out the form and they receive the denial- the denial then gets forwarded to the provider who can attach it to the 2ndry claim.

Michele:
I have never completed one of those but it looks like it might work for your situation.

PMRNC:
Yes, this form is what you want. Patient has to complete it and attach a copy of a fully itemized bill you give them. My dad has to do this for his accupuncture to send to his secondary. BUT many plans follow Medicare rules so I would definetely verify coverage and eligibility with the secondary.

Christy:
thanks ladies! I was able to successfully appeal the claims and get them paid without the rigmarole of getting this form.

It was only a problem with certain new NY Anthem BCBS EPOs- the older plans always paid no problems. Hopefully Anthem EPO will catch on soon!

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