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. 
 
Accelerated-and-Advanced-Payments-Fact-Sheet
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


Article Author:
Lori Shore, CPC, RCC, RCCIR, FRBMA 
Vice President, Coding Education and Compliance
MBMS, LLC
lshore@mbms.net
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