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Advanced Payment Forms & States/MAC Listing
by Lori Shore | Apr 07, 2020
Please use the below link to identify your correct Medicare Area Contractor (MAC).
Medicare MACs by state
Once you determine which MAC (carrier and/or “J” number) you can choose the corresponding form to submit your Medicare Payment Advancement Request.
Advanced Payment Request Certification
Accelerated and Advanced Payment Form - JL
Request For Accelerated or Advance Payment
Advance Payment Request Form - Noridian E
Advance Payment Request Form -Noridian F
Palmetto CMS Form
Request For Accelerated Payment
Lori Shore, CPC, RCC, RCCIR, FRBMA
Vice President, Coding Education and Compliance
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