This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services on January 1, 2018 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form CMS-1490S?
A: Form CMS-1490S, also known as Patient's Request for Medical Payment, is a form used by Medicare beneficiaries to request reimbursement for medical services.
Q: Who can use Form CMS-1490S?
A: Any Medicare beneficiary who wants to be reimbursed for medical services that were not billed directly to Medicare can use Form CMS-1490S to submit a request for payment.
Q: What kind of medical services can be claimed using Form CMS-1490S?
A: Form CMS-1490S can be used to claim reimbursement for a variety of medical services, including doctor visits, hospital stays, lab tests, durable medical equipment, and more.
Q: How do I fill out Form CMS-1490S?
A: To fill out Form CMS-1490S, you will need to provide your personal information, the details of the service you are seeking reimbursement for, and attach any necessary supporting documentation, such as bills or receipts.
Download a fillable version of Form CMS-1490S by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services.