Saturday, April 9, 2011

CMS 1500 OCR - guidelines and tips for clean claim

Optical Character Recognition (OCR)

BCBSF uses OCR scanning equipment to process paper claims. OCR is an automated system that reads
and interprets the characters in each block submitted on the claim form. The information is then sent into
the claims processing system. The more accurately the claim is completed, the less manual intervention
is necessary.

The following guidelines will help in preparing paper claims for OCR scanning:

• Form: Print the claim information in black ink on a blank, red ink CMS-1500 or UB-04 form. You may
also use software programs, which print both the form and the claim information in black ink. Do not
fold, staple or tape your claim.

• Alignment: Align all information within the designated field.

• Font: Use upper case letters in Courier font, size 10 (CMS-1500) or size 12 (UB-04). Do not bold or
italicize font.

• Characters: Do not use special characters (e.g., dollar signs, decimals, dashes, zeros or sevens with

• Names: Omit any titles, such as “Mr.” or “Mrs.” Enter the last name first, followed by a comma, then
the first name.

• Dates: Use an eight-digit format for dates and do not space between numbers (e.g., enter June 15,
2008 as 06152008).

• Time: Use a four-digit format for time, referred to as “units” in block 24G (e.g., enter 1 hour 30
minutes as 0130).

Rejected Claims

All paper claims go through “front-end” edits that verify eligibility information. Claims that cannot be
scanned by OCR will be returned to the provider with an accompanying explanation. If the claim is
returned, it must be submitted as a new claim; not a “corrected” claim. Returned claims are rejected prior
to processing; therefore, there is not an original claim to correct in the system.

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