1. (Hospital) Sends their Medicare intermediary either:
    • SSA 1453, Inpatient Hospital and Extended Care Admission and Billing, for inpatient services, or
    • SSA 1483, Provider Billing for Medical and Other Health Services, for outpatient or home services.
  2. (Hospital) Sends copy of form to Bureau of Claims Processing after Medicare has decided on payment.
  3. (Bureau of Claims Processing) Figures amount of coinsurance and/or deductible due.
  4. (Doctor) Sends SSA 1490, Request for Medicare Payment, for non-routine services to their Medicare intermediary.

    NOTE: Doctors do not bill for routine services. Payment for their services is made to hospital. 

  5. (Doctor) Sends copy of SSA 1490 to Bureau of Claims Processing after Medicare has decided on payment.
  6. (Bureau of Claims Processing) Figures amount of coinsurance and/or deductible due.