US · guidance
CMS Pub. 100-04, ch. 1, § 10.1.9.8
Transfer of Claims Material Between Carrier and
Intermediary (FI)
(Rev. 2474, Issued: 05-18-12, Effective: 07-20-12, Implementation;-7-20-12)
If a beneficiary erroneously submits a Form CMS-1490 (beneficiary-filed claim form) to
a carrier with an itemized bill for services that must be paid by the FI, the carrier
forwards such claims to the FI for the necessary action. The FI will inform the provider to
submit a claim once the information is received from the carrier.
If the claim covers a combination of services both within and outside the carrier’s
jurisdiction the carrier should retain the Form CMS-1490 and any claims material needed
for processing and forward a photocopy of the Form CMS-1490 and other claims
materials to the other involved carrier(s) or FI(s). The carrier should notify the
beneficiary when it transfers the claim.
The patient’s signature on the Form CMS-1490 satisfied the signature requirement and
protects the filing date for the provider billings. (See §70.1 for time limitations for filing
claims).
History
(Rev. 2474, Issued: 05-18-12, Effective: 07-20-12, Implementation;-7-20-12)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
8a4927914408f16a776ac11e78d4aeca49346f3d99dabf9467d34f3d9a37945b
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