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The CMS-1500 form is the official standard Medicare and Medicaid health insurance claim form required by the Centers for Medicare Medicaid Services (CMS) of the U.S. Department of Health Human Services.
Mail the claim form to your states Medicare contractor to process the claim. Visit CMS.gov for a list of contractors by state. If you are not sure where to send the form, contact Medicare at 1-800-633-4227 (for TTY services, call 1-877-486-2048), 24 hours a day, seven days a week.
The first thing youll need to do when filing your claim is to fill out the Patients Request for Medical Payment form. With this form, youll provide most of the information that Medicare will need to process your claim. The form will ask you to include: the reasons why you saw your healthcare professional.
If youre 65 or older, you can enroll online for Parts A and B, or Part A only. You can delay Part B if youre already covered through an employer group health plan. The application is for retirement benefits and Medicare, or Medicare only.
Beneficiaries can submit their own claims for certain services when a provider wont file a claim. However, you cannot file a claim with Original Medicare for diabetic test strips, Part B drugs, or equipment paid for under the DMEPOS Competitive Bidding Program.

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Alabama recognizes two standard claim forms (UB-04 and CMS-1500) and three Medicaid non-standard claim forms (Pharmacy, Dental, and one Medicare/Medicaid-related claim form). The providers provider type determines which claim type to bill, as illustrated in the table below.
Medicaid claims, except inpatient claims and nursing facility claims, must be received by NCTracks within 365 days of the first date of service to be accepted for processing and payment. Medicaid hospital inpatient and nursing facility claims must be received within 365 days of the last date of service on the claim.

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