How to File a Test Claim With Medicare

Most Medicare beneficiaries should never have to file a claim themselves. Medicare automatically makes a monthly payment to private insurance companies for those with a Medicare Advantage Plan. The doctors of all other Medicare beneficiaries will file the claims. In rare circumstances, your doctor may neglect to file a claim for services performed, such as a diagnostic test. File your claim for the medical test within a maximum of one year from the date of the test. Depending on the type of test, Medicare may require that you file the claim even sooner.

Things You'll Need

• Payment form
• Instructions
• Insurance card
• Copies
• Bill

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Instructions

• 1

  Call your doctor's office, and request that it file the Medicare claim. If it fails to do so in a timely manner, call Medicare and request the specific deadline for filing for the type of test you had done. Contact Medicare at 800-MEDICARE.

• 2

  Download and print the "Patient's Request for Medical Payment" from the Medicare website or request the form from Medicare (see References). Download the instructions for the form, and review them. If you ask Medicare to mail you the form, it will enclose the instructions.

• 3

  Write your full name in the space provided, exactly as it appears on your insurance card. Write your claim number (also on your insurance card), your address, phone number and gender in the spaces provided.

• 4

  Answer the medical questions related to your claim in Section 4 and indicate what the medical test was for. Write down your employment and policyholder information in Section 5.

• 5

  Sign your name, and write the date in Section 6.

• 6

  Make a copy of the bill from the medical test. The itemized bill must show the date and place of the test, brief description of the test and your diagnosis. If the bill does not show the diagnosis, indicate this in Section 4 of the form. The bill also must show the doctor who performed the test. If the bill lists more than one doctor, circle the name of the doctor who performed the test.

• 7

  Make a copy of the completed form for your records and keep the original bill.

• 8

  Mail the form and the copy of the bill to the address indicated in the instructions. Find the state in which you had the test performed, even if you live in a different state, and mail the documents to the address indicated for that state.