Who completes the CMS-460 form?

The CMS-460 form, known as the Medicare Enrollment Application for Qualified Medicare Beneficiary (QMB) Program, is specifically designed for use by providers and suppliers who wish to enroll in Medicare and indicate their participation in the QMB program. This form is essential for formalizing the agreement between the provider or supplier and Medicare, ensuring that services supplied to qualified patients under this program are billed correctly.

Providers and suppliers are responsible for filling out this form as they must attest to their compliance with Medicare requirements and the appropriate billing practices associated with the QMB program. While patients may provide the necessary information or documents related to their eligibility, it is the providers and suppliers who complete and submit the CMS-460 to enable consistent billing and to ensure that qualified patients receive the benefits entitled to them.

Other potential choices involve entities that do not directly complete the CMS-460. Patients may contribute relevant details but ultimately do not fill out or submit this form. Insurance companies are not involved in this process, as the form pertains directly to the Medicare system and is not necessary for their operations. Billing specialists may assist in the broader billing process but do not typically complete the CMS-460, which is specifically aimed at enrolling providers and suppliers into the Medicare program. Thus, the correct