- Introduction
- About Provider Outreach and Education
- ABN for Not Reasonable and Necessary Denials
- Appeals/Reopenings
- Assignment of Benefits
- Comprehensive Error Rate Testing
- CMS-1500 Claim Form
- Deceased Beneficiary Claims
- Electronic Data Interchange
- Evaluation and Management Services
- Fraud and Abuse
- Health Professional Shortage Area
- Hospice
- Limiting Charge
- Medical Policy Development
- Medigap
- Modifiers
- Nonphysician Practitioners
- National Provider Identifier
- Participation Program
- Payment Floor Standards
- Provider Enrollment
- Refunds and Overpayments
- Ordering and Referring Claims Information
- Return/Reject
- Standard Remittance ANSI Codes and Remittance Advice
- Appendix 1: Forms
- Appendix 2: Glossary
- Appendix 3: Place of Service Codes
Medicare Part B 101
Deceased Beneficiary Claims
Table of Contents
Deceased Beneficiary Claims
Medicare law outlining the payment of the medical bills of deceased Medicare patients requires that when the bill is unpaid and the physician does not agree to accept the allowed amount as the full charge, payment may be made to a person who assumes a legal obligation to pay for the services and files a request for payment.
Unpaid Bills
If the nonparticipating physician will not accept assignment, an individual who wishes to claim benefits for services must submit the following:
- A signed statement which reads, “I have assumed the legal obligation to pay (name of physician) for services furnished (name of deceased patient) on (date[s] of service). I hereby claim any Medicare benefits due for these services.”
- A completed CMS-1500 claim form. The claimant must sign in the patient signature space, Item 12, or equivalent record field for electronic transmissions.
- A signed statement from the physician confirming the provider’s refusal to accept assignment. The statement should read: “I, (name of physician) will not accept assignment for the services furnished to (deceased Medicare patient name) on (dates of service).”
- The signed statement by the physician refusing to accept assignment is needed because the law requires the provider be given first opportunity to claim payment for unpaid bills. Once payment is issued to a person who assumes a legal obligation to pay the bill, the government has no further obligation with respect to the services involved and the provider can no longer qualify for payment from Medicare.
- An itemized bill identifying the claimant as the person to whom the physician looks to for payment.
Paid Bills
Please indicate “paid” on the bill(s) and the name and address of the person(s) who paid them.
Assigned Claims
If the physician accepts assignment, no signature of the deceased Medicare patient’s family member is necessary.
Reviewed 10/10/2023