How to Use The CMS-1500 Claim Form

by Karen on August 30, 2011

Even though most medical billing is performed electronically, there are still some instances when paper claims are made. The paper claim form is called the CMS-1500 and it is a universal form used by healthcare providers to submit claims and invoices to insurance companies and carriers. CMS stands for Centers or Medicare and Medicaid Services. The CMS-1500 claim form and how to use it is available through healthcare web sites, the Medicare and Medicaid web sites and billing printing services.

The CMS-1500 forms are red and white and designed exclusively for Centers for Medicare and Medicaid Services. They were originally known as the Health Care Finances Association 1500 form and are used to report claims to the National Provider Identifier.

There are a variety of web sites that offer information regarding the CMS-1500 claim forms and how to use it. There are programs and booklets available for a price that walks the person filling out the paper work through the form step by step. There are also businesses that print the CMS-1500 forms and instructions. They are available in boxes of 100 or more and can be purchased online. There are also government and health care web sites that offer instructions about the CMS-1550 form and how to use it.

The CMS-1500 Form Not That Complicated

The CMS-1500 form and how to use is not as complicated as it may look. One important thing to remember when filling out the form is not to use commas. Even though it is a paper form and filled out freehand, it is still read as an optical document. The form includes the patient’s name and identification number, birth date, mailing address, telephone number, marital status and employment.

Other information includes other than Medicare or Medicaid insurance coverage, and if it will be the primary claim for the patient. The form is signed and dated by the patient or representative. The date of the onset of the illness or date of the accident is noted.

If the patient cannot work due to illness or injury, additional information will be required, as well as the name of the healthcare provider along with their national Provider Identification number. If outside lab or testing work is performed, the cost of that service will be provided in the appropriate box. Do not use decimal points when filling in costs.

It Must Be Completely Filled In

The form must be completely filled in, or it may be returned for further information and the process will be delayed. The form must be written legibly in order for it to be processed. All health service providers must be listed along with their identification numbers must be noted for the provider to be reimbursed. The appropriate ICD codes must be used, or the claim could be rejected.

The CMS-1500 form and how to use it is not overly complicated, but it does take billing code knowledge to fill out the form properly to avoid delay or denial of the claim. If the form is returned for any reason, the reasons will be explained.

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