Cms 1500 Form - Completing it Correctly

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

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Cms 1500 forms are the universal claim forms used by medical providers to submit claims for their services to the insurance 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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Health Insurance Claim Form 1500

It is very prominent that the Cms 1500 forms are completed properly to ensure that exact payment is made. If the form is not completed properly, the claim may be denied by the insurance carrier. Many providers have custom supervision software that completes the forms for them, but the data must still be loaded into the custom supervision software schedule properly in order for it to be printed out in the right format.

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

If you do not have all of the indispensable 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 insurance 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. another 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 insurance carrier. When the claim is scanned, it will deny out stating they can't recognize 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 completely and correctly. This will make a big contrast in your lowest line.

Copyright 2008 - Michele Redmond

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