Tuesday, June 22, 2010

Tips for submitting error-free paper claims

• Use only an original red-ink-on-white-paper Form CMS-1500 claim form.
• Use dark ink
.• Do not print, hand-write, or stamp any extraneous data on the form.
• Do not staple, clip, or tape anything to the Form CMS-1500 claim form.
• Remove pin-fed edges at side perforations
.• Use only lift-off correction tape to make corrections.
• Place all necessary documentation in the envelope with the Form CMS-1500 claim form.

• Do not use italics or script.
• Do not use dollar signs, decimals, or punctuation.
• Use only upper-case (CAPITAL) letters.
• Use 10- or 12-pitch (pica) characters and standard dot matrix fonts.
• Do not include titles (e.g., Dr., Mr., Mrs., Rev., M.D.) as part of the beneficiary’s name.
• Enter all information on the same horizontal plane within the designated field
.• Follow the correct Health Insurance Claim Number (HICN) format. No hyphens or dashes should be used. The alpha prefix or suffix is part of the HICN and should not be omitted. Be especially careful with spouses who have a similar HICN with a different alpha prefix or suffix.
• Ensure data is in the appropriate field and does not overlap into other fields
.• Use an individual’s name in the provider signature field, not a facility or practice name.

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