1. Blank Cms 1500 Claim Form Download
2. Cms 1500 Claim Form Instructions

Tips for Filling the Template

It is very important to ensure the information is accuracy and exactness when you are filling the health insurance claim form 1500. What's more, to ensure the completeness of the form, it is also important to make sure that all fields are duly filled. Considering the novelty and diversity of the CMS 1500, filling out such a form can be quite daunting, especially for those who are not familiar with the field. The following tips will help you fill out CMS 1500 successfully and accurately:

Simply choose the Blank CMS 1500 - 2012 option in either window. Insurance Questions window. Process Insurance Claims window. When printing a Blank CMS 1500 form, the claim form itself will print in red, as is seen on the pre-printed forms, and the claim information will print in black ink. To process this claim. I also request payment of government benefits either to myself or to the party who accepts assignment below. APPROVED OMB-0938-0999 FORM CMS-1500 (08/05) Title: CMS 1500 Keywords: F245-127-000 Provider Billing CMS 1500 HCFA 1500 Created Date.

Always use Pica or Arial fonts to fill out these forms. The font size is between 10 and 12.

Fill the form with capital letters and always use black ink or black fonts.

Do not use italics or broken characters, dot matrix fonts, stylized fonts, or red ink when filling out the CMS 1500 form.

Make sure that the data you enter is in the middle of the box and the edges does not be touched.

Use standard codes in various fields and never use any narrative text.

Remember that the size of the form you submitted is 81⁄2' x 11'. So, ensure to remove all the perforations. Also, it is important to make sure that all other attachments to the form are smaller than the size of the form.

Never use stickers or rubber stamps and your name and address on forms.

Do not fill in any special characters on the form, such as hyphens, periods, same marks, dollar signs, etc.

Blank Cms 1500 Claim Form Download

Make sure you submit the original form and keep a photocopy for your reference. Any uncommitted forms will not be processed.

What Is a CMS 1500 Form

Developed by the National Uniform Claim Committee (NUCC), the CMS-1500 form is a standard claim form, that is used by all of the non-institutional medical providers or suppliers to bill Medicare carriers and durable medical equipment regional carriers (DMERCs) when a provider meets the requirments from the Administrative Simplification Compliance Act (ASCA) for a waiver for electronic submission of medical claim form 1500. It is also used for the billing of some Medicaid agencies (more details you can contact your Medicaid agency).

The CMS 1500 Template Format

The CMS 1500 claim form is readily available from office supply stores, the U.S. Government Printing Office, and local print companies throughout the country. The format of CMS 1500 claim form is available in single, multiple, laser, continuous feed and other options for your choice, totally depending on the printer you are using and your requirements.

Category
Category	Business Software
Subcategory	Accounting & Billing Software

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• All Versions

  5.0

  out of 1 votes

Pros

The form worked perfectly and produced clean legible forms right from the beginning. I printed black text on pre-printed CMS-1500s with absolutely no alignment problems! The software paid for itself the first night I used it.

Cons

No electronic billing

Summary

Medicare will be sooo much happier with my claims now and I'll get paid faster. How's that for a win-win situation?

What's new in version 02-12
ICD-10 Ready. Now with Built-In ICD-10 Indicator. Optional Form Calculations: Automatically adds up the charges (1-6 in Box 24F). Billing Package available.

General
Publisher	Fiachra Forms
Publisher web site	https://fiachraforms.com/
Release Date	March 01, 2014
Date Added	March 15, 2016
Version	02-12

Category
Category	Business Software
Subcategory	Accounting & Billing Software

Operating Systems
Operating Systems	Windows 7/8/10
Additional Requirements	Adobe Reader 11

Download Information
File Size	4.92MB
File Name	CMS-1500-PDF-Demo.zip

Popularity
Total Downloads	3,247
Downloads Last Week	9

Pricing
License Model	Free to try
Limitations	Watermark on output
Price	$29

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Cms 1500 Claim Form Instructions

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