Forms - Part A - WPS Medicare

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J5 MAC Part A Providers serving beneficiaries in Iowa, Kansas, Missouri and Nebraska

HIGLAS Transition

Recovery Audit Contractor

C-SNAP

CERT

Most Popular

Interactive Voice Response (IVR)

Direct Data Entry (DDE)

Spotlight

Submission of Medicare Secondary Payer (MSP) Claims

Answers to Frequently Asked Questions (FAQs) Regarding Extended Repayment Plans (ERP)

Swine Flu Information

Frequently Asked Questions (FAQs)

Claims Processing/Payment Issues

Call Center Status

C-SNAP : Available

Customer Service : Available

EDI : Available

System Status

C-SNAP : Available

FISS : Available

IVR : Available

Forms Part A

Appeals (Redetermination Forms) Iowa Kansas Missouri Nebraska	Appeals (Reconsideration Form) Iowa Kansas Missouri Nebraska Appointment of Representative
Audit & Reimbursement (A&R) PS&R Order Form	CMS Forms CMS Forms
Enrollment CMS 855A Enrollment Application CMS 588 Form Helpful Hints for Form CMS-855	Financial CMS 838 Credit Balance Form