Insurance Forms

To correct the Patient-/System-abuse that’s been happening in recent-years, Medicare has instituted new requirements for processing Claims (read, first, the “Preparation-Checklist for Insurance-Claims” in the downloadable-pdf).

And because Medicare “instantly”-declines “illegible”-Claim-forms, and to save you from having to use a typewriter to complete the necessary forms, the downloadable-pdf is designed for “fill-in” using your computer.

There are two steps to complete these forms:

1)  Click “Download Insurance Forms”, the pdf will open, and the forms can be filled-in online.

2)  Once the forms are filled-in, print-out the forms, complete them by signing them in blue-ink, and mail them to our Office -- include a note from you as to “Best-times to contact you”:

ROMETECH
9680 West Tropicana Avenue
Suite 110-104
Las Vegas, NV  89147

Once we’ve received the completed-forms, we will call you.  During that call, we’ll complete your Payment.  Your “Payment”-amount will be a function of whether or not you have secondary-Insurance, which covers the 20% that Medicare doesn’t -- your “Payment”-amount will also be a function of whether you choose to file your own Claim with Medicare, or assign your Claim to ROMETECH.

Once the payment is complete -- which includes ROMETECH’s receipt of the funds from Medicare (and your secondary-Insurance company, if you have such), we will ship your order to the Shipping-Address you provided in the “Purchaser’s Information”-form included in the “Insurance Forms”-pdf.

If you have any questions, or need assistance with this, call us at:

1-866-329-5699
(toll-free)