Medicare Claims address-When and How to file for reimbursement
If you have original Medicare then you never need to file a Medicare claim except in few rare cases which we are going to discuss later. Because according to the law, requires Medicare providers and suppliers to file Medicare claims for the covered services they render to the beneficiary or Members.
If you are enrolled in Medicare Advantage Plan i.e. Part C, then you need to find out managed care plan by checking eligibility and file claims directly to them to get paid. Because Medicare Insurance pays these private insurance companies a set amount each month.
When to File a Claim for reimbursement?
As we informed initially only in very rare cases patient has to file a Medicare claim if:
- Doctor or Supplier won’t file a claim or Refuses to file a claim.
- Provider or Supplier not enrolled in Medicare.
Medicare claims must be filed no later than 12 months from the date you receive the health care services. So check your Medicare summary Notice issued every 3 months from Medicare, if you get any services from provider or suppliers to make sure claims are being filed timely.
If suppose provider or supplier didn’t file a Medicare claim, the first thing you have to do is contact them and ask them to file a claim. In most cases they will resolve the issue if you bring them to their attention.
You should file the claim, if provider or supplier still hasn’t file the claim and it’s close to the end of the time limit. Call Medicare number at 1-800-633-4227 for more assistance.
How to file a claim for Medicare reimbursement?
Fill out the Patient’s request for Medical payment form and follow the instructions for the type of claim you are filing.
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms1490s-english.pdf
- PART B Services
Below is the address you need to return the completed claim form, itemized bill, supporting documentation and letter explaining in detail for the reason you are submitting the claim:
| State | Please send the completed form to the below Medicare Claims address | |
| Alabama | Palmetto GBA Medicare Part B Claims P.O. Box 100306 Columbia, SC 29202-3306 | |
| Alaska | Noridian Healthcare Solutions P.O. Box 6703 Fargo, ND 58108-6703 | |
| American Samoa | Noridian Healthcare Solutions P.O. Box 6777 Fargo, ND 58108-6777 | |
| Arizona | Noridian Healthcare Solutions P.O. Box 6704 Fargo, ND 58108-6704 | |
| Arkansas | Novitas Solutions P.O. Box 3098 Mechanicsburg, PA 17055-1816 | |
| California (Northern) | Noridian Healthcare Solutions P.O. Box 6774 Fargo, ND 58108-6774 | |
| California (Southern) | Noridian Healthcare Solutions P.O. Box 6775 Fargo, ND 58108-6775 | |
| Colorado | Novitas Solutions P.O. Box 3107 Mechanicsburg, PA 17055-1823 | |
| Connecticut | National Government Services, Inc. P.O. Box 6178 Indianapolis, IN 46206-6178 | |
| Delaware | Novitas Solutions P.O. Box 3397 Mechanicsburg, PA 17055-1842 | |
| District of Columbia (Washington, DC) | Novitas Solutions P.O. Box 3396 Mechanicsburg, PA 17055-1841 | |
| Florida | First Coast Service Options, Inc. P.O. Box 2525 Jacksonville, FL 32231-0019 | |
| Georgia | Palmetto GBA Medicare Part B Claims P.O. Box 100306 Columbia, SC 29202-3306 | |
| Guam | Noridian Healthcare Solutions P.O. Box 6777 Fargo, ND 58108-6777 | |
| Hawaii | Noridian Healthcare Solutions P.O. Box 6777 Fargo, ND 58108-6777 | |
| Idaho | Noridian Healthcare Solutions P.O. Box 6701 Fargo, ND 58108-6701 | |
| Illinois | National Government Services, Inc. P.O. Box 6475 Indianapolis, IN 46206-6475 | |
| Indiana | Wisconsin Physicians Service P.O. Box 8940 Madison, WI 53708-8940 | |
| Iowa | Wisconsin Physicians Service P.O. Box 8550 Madison, WI 53708-8550 | |
| Kansas | Wisconsin Physicians Service P.O. Box 7238 Madison, WI 53707-7238 | |
| Kentucky | CGS Administrators, LLC P.O. Box 20019 Nashville, TN 37202 | |
| Louisiana | Novitas Solutions P.O. Box 3097 Mechanicsburg, PA 17055-1815 | |
| Maine | National Government Services, Inc. P.O. Box 6178 Indianapolis, IN 46206-6178 | |
| Maryland | Novitas Solutions P.O. Box 3398 Mechanicsburg, PA 17055-1843 | |
| Massachusetts | National Government Services, Inc. P.O. Box 6178 Indianapolis, IN 46206-6178 | |
| Michigan | Wisconsin Physicians Service P.O. Box 8987 Madison, WI 53708-8987 | |
| Minnesota | National Government Services, Inc. P.O. Box 6475 Indianapolis, IN 46206-6475 | |
| Mississippi | Novitas Solutions P.O. Box 3129 Mechanicsburg, PA 17055-1834 | |
| Missouri | Wisconsin Physicians Service P.O. Box 14260 Madison, WI 53708-0260 | |
| Montana | Noridian Healthcare Solutions P.O. Box 6735 Fargo, ND 58108-6735 | |
| Nebraska | Wisconsin Physicians Service P.O. Box 8667 Madison, WI 53708-8667 | |
| Nevada | Noridian Healthcare Solutions P.O. Box 6776 Fargo, ND 58108-6776 | |
| New Hampshire | National Government Services, Inc. P.O. Box 6178 Indianapolis, IN 46206-6178 | |
| New Jersey | Novitas Solutions P.O. Box 3030 Mechanicsburg, PA 17055-1802 | |
| New Mexico | Novitas Solutions P.O. Box 3107 Mechanicsburg, PA 17055-1823 | |
| New York | National Government Services, Inc. P.O. Box 6178 Indianapolis, IN 46206-6178 | |
| North Carolina | Palmetto GBA – J11 MAC Mail Code: AG-600 P.O. Box 100190 Columbia, SC 29202-3190 | |
| North Dakota | Noridian Healthcare Solutions P.O. Box 6706 Fargo, ND 58108-6706 | |
| Northern Mariana Islands | Noridian Healthcare Solutions P.O. Box 6777 Fargo, ND 58108-6777 | |
| Ohio | CGS Administrators, LLC P.O. Box 20019 Nashville, TN 37202 | |
| Oklahoma | Novitas Solutions P.O. Box 3107 Mechanicsburg, PA 17055-1823 | |
| Oregon | Noridian Healthcare Solutions P.O. Box 6702 Fargo, ND 58108-6702 | |
| Pennsylvania | Novitas Solutions P.O. Box 3418 Mechanicsburg, PA 17055-1854 | |
| Puerto Rico | First Coast Service Options, Inc. P.O. Box 45036 Jacksonville, FL 32231-5036 | |
| Rhode Island | National Government Services, Inc. P.O. Box 6178 Indianapolis, IN 46206-6178 | |
| South Carolina | Palmetto GBA – J11 MAC Mail Code: AG-600 P.O. Box 100190 Columbia, SC 29202-3190 | |
| South Dakota | Noridian Healthcare Solutions P.O. Box 6707 Fargo, ND 58108-6707 | |
| Tennessee | Palmetto GBA Medicare Part B Claims P.O. Box 100306 Columbia, SC 29202-3306 | |
| Texas | Novitas Solutions P.O. Box 3108 Mechanicsburg, PA 17055-1824 | |
| Utah | Noridian Healthcare Solutions P.O. Box 6725 Fargo, ND 58108-6725 | |
| Vermont | National Government Services, Inc. P.O. Box 6178 Indianapolis, IN 46206-6178 | |
| Virginia (Arlington and Fairfax Counties, including city of Alexandria) | Novitas Solutions P.O. Box 3396 Mechanicsburg, PA 17055-1841 | |
| Virginia (The rest of the state.) | Palmetto GBA – J11 MAC Mail Code: AG-600 P.O. Box 100190 Columbia, SC 29202-3190 | |
| Virgin Islands | First Coast Service Options, Inc. P.O. Box 45098 Jacksonville, FL 32231-5098 | |
| Washington | Noridian Healthcare Solutions P.O. Box 6700 Fargo, ND 58108-6700 | |
| West Virginia | Palmetto GBA – J11 MAC Mail Code: AG-600 P.O. Box 100190 Columbia, SC 29202-3190 | |
| Wisconsin | National Government Services, Inc. P.O. Box 6475 Indianapolis, IN 46206-6475 | |
| Wyoming | Noridian Healthcare Solutions P.O. Box 6708 Fargo, ND 58108-6708 | |
- DME-Durable Medical Equipment
Please find the below address to file DME services claims
| State | Return your Completed form to below Medicare Claims address: |
| Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont | Noridian Healthcare Solutions P.O. Box 6780 Fargo, ND 58108-6780 |
| Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, Wisconsin | CGS Administrators, LLC P.O. Box 20013 Nashville, TN 37202 |
| Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, West Virginia | CGS Administrators, LLC P.O. Box 20010 Nashville, TN 37202-0010 |
| Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, Wyoming | Noridian Healthcare Solutions P.O. Box 6727 Fargo, ND 58108-6727 |
- Medical Services you got aboard a ship use these instructions
- Claims for services you got in Canada or Mexico
- Claims for services you got in a foreign hospital