Form CMS-1490S Patient's Request for Medical Payment

What Is Form CMS-1490S?

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.

FAQ

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.