Wednesday, June 9, 2010

How to Filing Form CMS-1500 - Tips to submit claim

Filing Form CMS-1500

Medicare Part B physicians may use the red-printed Form CMS-1500 to file various health insurance claims to private insurers and government programs. However, payment for paper claims takes substantially longer than payment for electronically submitted claims. Generally, electronic claims can be paid 14 days after submission, as opposed to paper claims that process in about four weeks. 

How Paper Claim Submission 

Works When filing paper claims, physicians must type or machine-print all mandated claim fields on the red-printed Form CMS-1500 and mail it to the local carrier. Some carriers may be able to accept a black and white copy of Form CMS-1500. Other carriers may not accept black and white copies of the form if they are using Optical Character Recognition (OCR) equipment to process the form.

Optical Character Recognition 

Carriers that process claims with OCR, use an automated scanning process similar to scanners that read price labels in grocery stores. OCR claims processing is faster and more accurate than systems requiring manual input. However, to work properly, OCR must accurately read and interpret the characters entered in each field. It reads only typed or machine-printed data. Only an original, red and white Form CMS-1500 may be submitted. Black and white photocopies cannot be machine read and will be returned. 

After claims information is scanned, it is transmitted to the claims processing system, where it is validated. 

To ensure accurate, quick claim processing, the following guidelines must be followed: 

*Do not staple, clip, or tape anything to Form CMS-1500
*Place all necessary documentation in the envelope with Form CMS-1500 
* Put the patient ’ s name and Medicare number on each piece of documentation submitted 
* Use dark ink 
* Use only upper-case (CAPITAL) letters 
* Use 10 or 12 pitch (pica) characters and standard dot matrix fonts 
* Do not mix character fonts on the same form 
* Do not use italics or script 
* Avoid using old or worn print bands or ribbons
* Do not use dollar signs, decimals, or punctuation 
* Enter all information on the same horizontal plane within the designated field 
* Do not print, hand-write, or stamp any extraneous data on the form 
* Use only lift-off correction tape to make corrections 
* Ensure data is in the appropriate field and does not overlap into other fields 
* Remove pin-fed edges at side perforations 
* Use only an original red-ink-on-white-paper Form CMS-1500

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