Question

What is a CMS-1500 form? What is the purpose of that form? Why is it important in healthcare? What are some of the basic guidelines that must be followed when submitting a CMS-1500 claim?

Answer 1

Form CMS-1500 is the standard paper claim form used to bill an insurance for rendered services and supplies. It provides information about the client, their corresponding insurance policy, and their diagnosis and treatment.

#. Bill can be claimed by the following persons by using the CMS 1500 :

Physician services

Physician assistants

Nurse practitioners

Clinical nurse specialists

Nurse midwives

Certified registered nurse anesthetists

Clinical psychologists

Clinical social workers

Home dialysis supplies and equipment

Ambulance services

Clinical diagnostic laboratory services

#. Points to be kept in mind while preparing the CMS 1500 Claim Form :-

Ensure that all data is entered correctly and accurately in the correct fields.

Enter insurance information including the patient's name exactly as it appears on the insurance card.

Use correct diagnosis codes (ICD-9) and procedure codes (CPT/HCPCS) using modifiers when required.

Use only the physical address for the service facility location field.

Don't forget to include NPI information where indicated