Claim submission

How to Submit Claims 

Claims may be filed to the Medicare Part B carrier in one of two ways: 

* Electronic transmission from the physician ’ s office or from a billing service contracting with the physician

* Paper claim (Form CMS-1500) where not prohibited under the mandatory Medicare electronic filing requirements October 16, 2003 and later

Claims may be electronically submitted to Medicare from a physician ’ s office using a computer with software that meets electronic filing requirements. A sender number is issued, and claims are transmitted directly from the physician ’ s office, giving the physician control over timeliness and accuracy of claims. Medicare carriers offer free or low-cost billing software that allows electronic transmission directly to the Medicare carrier. Commercial software is also available that can be used to bill multiple health plans, including Medicare, as well as perform other practice management services. If the physician does not have a computer system meeting the requirements, a billing service may be used to submit claims. Either way, specific processing requirements–and benefits–are associated with filing claims electronically.