Cms 1500 Form - Completing it Correctly

1500 Health Insurance Claim Form - Cms 1500 Form - Completing it Correctly

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Cms 1500 forms are the universal claim forms used by curative providers to submit claims for their services to the assurance carriers. They are pre-printed red and white forms designed by the Centers for Medicare and Medicaid Services. They were formally known as Hcfa 1500 forms but they were redesigned to allow for the reporting of the Npi, or National victualer Identifier.

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1500 Health Insurance Claim Form

It is very important that the Cms 1500 forms are completed properly to ensure that exact cost is made. If the form is not completed properly, the claim may be denied by the assurance carrier. Many providers have convention management software that completes the forms for them, but the information must still be loaded into the convention management software agenda properly in order for it to be printed out in the right format.

Many of the assurance carriers have dissimilar requirements for what information goes in each box on the Cms 1500 form. For example, if you are billing an assurance carrier that requires authorization for the services being billed and they assign an authorization number, they may need that the authorization number be in box 23. Other carriers do not need that anyone be in box 23. It is important to know the dissimilar requirements for each of the assurance carriers that you bill to.

If you do not have all of the valuable boxes completed, or if they are not completed properly, the claim may be denied. For example, if you do not put the patient's date of birth on the Cms 1500 form, then the claim will most likely be denied out. Most assurance carriers scan the Cms forms and if all the required fields are not completed the claim is automatically denied without a human even touching it. an additional one thing that could cause an immediate denial is if the date of birth on the claim doesn't match what's on file with the assurance carrier. When the claim is scanned, it will deny out stating they can't identify the patient.

Many claims do not get paid on the first submission and in many cases it is due to the Cms form not being completed properly. In order to cut down on denials, make sure you are completing the forms wholly and correctly. This will make a big dissimilarity in your bottom line.

Copyright 2008 - Michele Redmond

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