What is a HCFA 1500 claim form?
The HCFA 1500 claim form, also known as CMS-1500, enables medical physicians to submit health insurance claims for reimbursement from various government insurance plans including Medicare, Medicaid and Tricare. The HCFA-1500 form (CMS-1500) is used to submit charges covered under Medicare Part B.
What is a condition code on 1500?
Background Information. Currently, Condition Codes are designed to allow the collection of information related to the patient, particular services, service venue and billing parameters which impact the processing of an Institutional claim.
What does HCFA form stand for?
HCFA: The Health Care Finance Administration, the part of the U.S. Department of Health and Human Services (HHS) that is responsible for administering Medicare and Medicaid.
Who fills out a HCFA 1500 form?
The HCFA-1500 (CMS 1500) is a medical claim form employed by doctors, nurses, and professionals, including chiropractors and therapists to process the medical claim of a patient.
What block on the CMS 1500 claim form is required to indicate a workers compensation claim?
Block 10
Claims Filing – Workers’ Compensation Use specific UB-04 occurrence codes or check the appropriate “yes” box in Block 10 of the CMS 1500 claim form, and indicate the external cause of injury codes (E codes) to enable HMSA to determine whether there is any potential third-party liability.
What is the only form of punctuation allowed on a CMS 1500?
Do not use punctuation (i.e., commas, periods) or other symbols in the address (e.g., 123 N Main Street 101 instead of 123 N. Main Street, #101). Report a 5 or 9-digit ZIP code. Enter the 9-digit ZIP code without the hyphen.
What information is required on CMS 1500 form?
Enter the patient’s mailing address and telephone number. On the first line enter the street address; the second line, the city and state; the third line, the ZIP code and Page 2 Instructions on how to fill out the CMS 1500 Form telephone number. If Medicare is primary, leave blank.