1500 Health Insurance Claim Form - What is it and Important Tips for completing. This is probably the most important form in medical billing and coding careers. Below is a great resource for learning how to correctly complete the form.
If you've had any medical billing coding training, you probably learned quickly the importance of and became very familiar with the CMS 1500 claim form.
The CMS 1500 claim form is currently the only accepted form for submitting paper claims to both government and commercial health insurance carriers. It is printed in red ink as shown on the right. The only forms accepted are the "official" forms printed in Flint OCR Red (J6983) ink.
There are lots of copies of the form available for download, but these cannot be used for submission because the red ink cannot be accurately reproduced. Most claims sent to insurance carriers are scanned using an optical character recognition scanner. This converts the information on the form into electronic format for processing by the carrier.
The CMS 1500 claim form (dated 08-05) replaced the outdated HCFA 1500 health insurance claim form (dated 12-90). One of the biggest changes for the CMS 1500 is the addition of the NPI field. There are several vendors who sell the CMS-1500 claim form in various configurations such as single sheet, continuous feed, laser, etc.
The NUCC (National Uniform Claim Committee) will be releasing the new CMS 1500 form soon - designated as the 02/12 form. The form is being updated to accommodate the changes in 5010, 837P and 5010A1 as well as prepare for the implementation of ICD-10. The changes will make the paper CMS form agree with electronic claim forms.
June 1st of 2013 providers can begin using the 02/12 CMS 1500 health insurance claim form. By October of 2013 the 02/12 version will replace the 08/05 version. After October 1st of 2013 the 08/05 version will no longer be accepted by insurance carriers - even if billing for an old claim.
Important tips for completing the CMS 1500 form:
If you need help filling out the CMS 1500 form, "How To Complete A CMS 1500 Form" on our Medical Billing Books page is a helpful and comprehensive Line by Line "how-to" guide to filling out the CMS 1500 form. Includes Easy to understand Line by line and box by box instructions.
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