fyllyoGovernment Forms
Form CMS-40B
Application for Enrollment in Medicare Part B
Fyllyo uses local AI to interpret your documents, calculate required answers and fill PDF forms. Review the answers and their sources before saving, without uploading client documents.
A simpler way to prepare a PDF.
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Choose a built-in template or set up your own blank fillable PDF once.
Add client documents
Drop in PDFs, scans, photos, Word files or typed notes. The AI reads them on your computer.
Review and save
Check the source lines, confirm key facts and edit the PDF. Uncertain values stay blank and flagged.
Form reference
Before you begin.
Use these notes as a starting point. Check the issuing agency’s current form and instructions for your client’s situation.
Open the source PDFFyllyo helps prepare PDFs. It doesn’t provide legal or tax advice, determine eligibility, or file forms for you.
Gather Essential Documents
Before you start filling out Form CMS-40B, ensure you have all necessary personal information at hand. This includes your full name, address, date of birth, Social Security number, and current health insurance details. Having these documents ready will streamline the process and help you avoid forgetting any critical details.
Details worth checking
Accurate Medicare Number Entry
Entering the Medicare number incorrectly can delay your application processing. This number must match exactly as it appears on your Medicare card, without extra spaces or incorrect characters.
Correct Name Order
Names must be listed in the order: last name, first name, and middle name. Incorrect sequencing can cause processing errors and identity confusion.
Complete Mailing Address
An incomplete address can lead to communication issues and delays in receiving important Medicare correspondence. All components of your address must be included.
Consistent Address Details
Mismatched city, state, or ZIP code with your address can cause mail delivery issues and processing delays.
Valid Phone Number Format
A phone number must be in a 10-digit format, including the area code. Incorrect formats can prevent timely communication.
Set up your own form once.
Fyllyo’s cloud service prepares a reusable template from your blank fillable PDF and setup instructions. No API key is required. Client documents stay on your computer, and subsequent filling runs locally. Check the first few filled forms carefully.
Mac with M1 or later · 16 GB memory recommended · About 8 GB free disk space