Basics of Claim Form 1500

CMS 1500 forms are the universal claim forms used by medical providers to submit claims for their services to the insurance 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.

The CMS form is sold by the United States government printer or any of your local printers in many different configurations such as single, multi-part or continuous feed. The original forms are used for making claim. You can get a copy from an online source but unfortunately, this cannot be used in making claims. This is because the form will be processed with the help of a scanner which require that the form be of certain color and quality, failure to which the contents of the form will not be read well.

It is very important that the CMS 1500 forms are completed properly to ensure that correct payment is made. If the form is not completed properly, the claim may be denied by the insurance carrier. Many providers have practice management software that completes the forms for them, but the information must still be loaded into the practice management software program properly in order for it to be printed out in the right format.

Many of the insurance carriers have different requirements for what information goes in each box on the claim form 1500. For example, if you are billing an insurance carrier that requires authorization for the services being billed and they assign an authorization number, they may require that the authorization number be in box 23. Other carriers do not require that anything be in box 23. It is important to know the different requirements for each of the insurance carriers that you bill to.