Yes! You can use AI to fill out Medicare Secondary Payer Employer Acknowledgement Form

CAR forms: Form SSA-44, Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event, Form I-90, Application to Replace Permanent Resident Card, Form 2441, Child and Dependent Care Expenses, Form WH-380-E, Certification of Health Care Provider, Form 4137, Social Security and Medicare Tax on Unreported Tip Income, Form 8959, Additional Medicare Tax, Form 8919, Uncollected Social Security and Medicare Tax, Form CMS-1763, Request for Termination of Medicare Coverage, Form CMS-855O, Medicare Enrollment Application, Form CMS-460, Medicare Participation Agreement, Form CMS-4040, Request for Enrollment in Medicare Part B, Form WH-380-F, Certification of Health Care Provider, Form W-10, Dependent Care Provider’s Identification, Form 1099-K, Payment Card and Third Party Network Transactions, Form CMS-40B, Application for Enrollment in Medicare Part B, Form SS-5-FS, Application for a Social Security Card, Form REG 195, Disabled Person Placard, Form AR-11, Alien's Change of Address Card, Form I-905, Application for Authorization to Issue Certification for Health Care Workers, Form I-131A, Application for Carrier Documentation

employer forms: Form 940, Employer’s Annual FUTA Tax Return, Form 8027, Employer’s Annual Information Return, Form DE 1, Commercial Employer Account Registration, Form 8994, Employer Credit for Paid Family and Medical Leave, Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, Form 941, Employer’s Quarterly Federal Tax Return, Form I-129CWR, Semiannual Report for CW-1 Employers, Form 941-X (Rev. April 2023), Adjusted Employer’s QUARTERLY Federal Tax Return or Claim for Refund, C139 – Employer’s Information Questionnaire (WCB Alberta), Form SS-4 (Rev. December 2025), Application for Employer Identification Number, City of Carlinville Application for Employment (An Equal Opportunity Employer), Form 941, Employer's QUARTERLY Federal Tax Return (Rev. March 2025), Easy Transfer Form: Moving Funds to an Employer-Sponsored Retirement Plan at TIAA, Form F10462, Moving Funds to an Employer-Sponsored Retirement Plan at TIAA, Moving Funds to an Employer-Sponsored Retirement Plan at TIAA, Form F10794, Cash Withdrawal or Rollover Transfer Payout Annuity for Private Employer Plans, DWC002, Employer’s report for reimbursement of voluntary payment, DWC001S, Employer’s first report of injury or illness, DWC Form-001, Employer’s first report of injury or illness, The E-Verify Memorandum of Understanding for Employers

L.A. Care forms: Form SSA-44, Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event, Form 2441, Child and Dependent Care Expenses, Form WH-380-E, Certification of Health Care Provider, Form 4137, Social Security and Medicare Tax on Unreported Tip Income, Form 8959, Additional Medicare Tax, Form 8919, Uncollected Social Security and Medicare Tax, Form CMS-1763, Request for Termination of Medicare Coverage, Form CMS-855O, Medicare Enrollment Application, Form CMS-460, Medicare Participation Agreement, Form CMS-4040, Request for Enrollment in Medicare Part B, Form WH-380-F, Certification of Health Care Provider, Form W-10, Dependent Care Provider’s Identification, Form CMS-40B, Application for Enrollment in Medicare Part B, Form I-905, Application for Authorization to Issue Certification for Health Care Workers, DHS-6696-ENG, Minnesota Health Care Programs Application (MNsure/DHS), California Department of Social Services (CDSS) Community Care Licensing Child Care Forms Packet (LIC 9150, LIC 282, LIC 627, LIC 700, LIC 995A, CDPH 286, LIC 9227), State of Illinois Department of Human Services (IDHS) – Bureau of Child Care and Development Child Care Application (Form IL444-3455), Form CH-006: PA-BH-Res-PCS, Oregon Behavioral Health Support Program Plan of Care Authorization (Plan of Care Request for Behavioral Health Residential or Personal Care Services), State of Illinois Department of Children and Family Services Medical Report on an Adult in a Child Care Facility (CFS 602), Carer Payment and Carer Allowance – Medical Report (SA431) for a child under 16 years

SEC forms: Form 4137, Social Security and Medicare Tax on Unreported Tip Income, Form 8919, Uncollected Social Security and Medicare Tax, Form SS-5-FS, Application for a Social Security Card, Form SSA-4-BK, Application for Social Security Benefits, Form I-485 Supp A, Adjustment of Status Under Section 245(i), Form 104, List of Creditors 20 Largest Unsecured Claims, Form SSA-8000-BK, Application for Supplemental Security Income (SSI), Form SSA-1042S, Social Security Benefit Statement, QBCC Licence Application Form – Mutual Recognition (Application under section 19 of the Mutual Recognition Act 1992 (Cwlth) and section 18 of the Trans-Tasman Mutual Recognition Act 1997 (Cwlth)), QBCC Licence Application Form – Company (Application made under section 33, Queensland Building and Construction Commission Act 1991), ACORD 140 (2014/12), Property Section (Attach to ACORD 125), Form SSA-3369-BK, Work History Report (Social Security Administration), European Public Prosecutor’s Office (EPPO) Application Form, Washington Single-Family Property Term Lease & Security Deposit Receipt (WA Single-Family Lease) | Revised 10/08/2025, Form 8919, Uncollected Social Security and Medicare Tax on Wages, VA Form 21-0781a, Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (PTSD) Secondary to Personal Assault, Louisiana Secretary of State – Notice of Change of Registered Office and/or Change of Registered Agent (Domestic Limited Liability Company) (R.S. 12:1308) (Form SS983, Rev. 01/24), Building Regulation 2021 (Queensland) – Section 143A(3) – Form 18 (Version 6, March 2023), Notice to the owner (where owner is not the client) that a private certifier has been engaged, Form SSA-827 (06-2024), Authorization to Disclose Information to the Social Security Administration (SSA), Intra-Brokerage Securities Transfer

Medicare forms: Form SSA-44, Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event, Form SSA-44, Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event, Form 4137, Social Security and Medicare Tax on Unreported Tip Income, Form 8959, Additional Medicare Tax, Form 8919, Uncollected Social Security and Medicare Tax, Form CMS-1763, Request for Termination of Medicare Coverage, Form CMS-855O, Medicare Enrollment Application, Form CMS-460, Medicare Participation Agreement, Form CMS-4040, Request for Enrollment in Medicare Part B, Form CMS-40B, Application for Enrollment in Medicare Part B, Medicare Enrolment Application (Australia) – Enrol in Medicare, Re-enrol/Extend Eligibility, Enrol a Newborn, and Register for My Health Record, Form 8919, Uncollected Social Security and Medicare Tax on Wages, CMS-855I, Medicare Enrollment Application for Physicians and Non-Physician Practitioners, Form CMS-855R, Medicare Enrollment Application - Reassignment of Medicare Benefits, CMS-855R, Medicare Enrollment Application: Reassignment of Medicare Benefits, CMS-855R, Medicare Enrollment Application: Reassignment of Medicare Benefits, Medicare Enrollment Application for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers, CMS-855S, 42 CFR Part 489 - Provider Agreements and Supplier Approval (Centers for Medicare & Medicaid Services), CMS-855B, Medicare Enrollment Application for Clinics/Group Practices and Other Suppliers, CMS-855A, Medicare Enrollment Application for Institutional Providers