Cms 1500 Form - Completing it Correctly

Cms 1500 forms are the universal claim forms used by curative providers to submit claims for their services to the guarnatee 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 provider Identifier.

It is very leading 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 guarnatee carrier. Many providers have institution management software that completes the forms for them, but the information must still be loaded into the institution management software agenda properly in order for it to be printed out in the right format. Many of the guarnatee carriers have dissimilar requirements for what information goes in each box on the Cms 1500 form. For example, if you are billing an guarnatee carrier that requires authorization for the services being billed and they assign an authorization number, they may wish that the authorization estimate be in box 23. Other carriers do not wish that anyone be in box 23. It is leading to know the dissimilar requirements for each of the guarnatee carriers that you bill to. If you do not have all of the principal 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 guarnatee 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. other 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 guarnatee 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 incompatibility in your bottom line. Copyright 2008 - Michele Redmond