Form CMS-18F5 Interview/SSA Claim System

Application for Enrollment in Medicare Part A, Internet Claim (iClaim) Application Screen, Modernized Claims System and Consolidated Claim (CMS-18F5)

Consolidated Claim Experience (CCE)- Medicare Claim Intake Screen Package_V 3.0

Interview/SSA Claim System (Modernized Claims System (MCS)/Consolidated Claim Experience (CCE))

OMB: 0938-0251