CMS 1500 Claim Forms
-
578670
Item:
Product Overview:
New 1500 CMS Claim Forms
As of April 1, 2014, Medicare will only process paper claims submitted on the revised CMS 1500 claim form
Allows healthcare providers to bill a patient's insurance company for reimbursement
As of April 1, 2014, Medicare will only process paper claims submitted on the revised CMS 1500 claim form
Allows healthcare providers to bill a patient's insurance company for reimbursement
- Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
- This form was revised to align the paper form with some of the changes in the electronic health care claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
- The most significant change was the addition of 8 diagnosis codes in field 21
- Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
- Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
- Form not available personalized
- Certified Chain of Custody; promotes sustainable forest management
- Size: 8-1/2x11"
CMS 1500 Claim Forms Reviews Summary
Allegro Medical does not endorse, recommend or sponsor any customer product reviews, ideas or advice.

(0)
(0)
(0)
(0)
(0)
Q&A: Question About?
CMS 1500 Claim Forms
Ask the community about this product and get answers. Share your knowledge and advice.
Learn More about Q&A. Learn about Q&A
Q&A allows customers to interact with one another in
asking product specific questions and receiving answers from
knowledgeable fellow customers and staff experts.
Unlike the lengthy one-to-one support media such as email, phone,
or live chat, Q&A captures those conversations and insights by
displaying them directly on the product detail page - for all future customers to see. A single answer now aids multiple customers.
![]()
0 Questions | 0 Answers
|
||
Part Number(s): 796 0018, 796 0019, 796 0020, 796 0024, 796 0023, 796 0022
Mfg Part Number(s): 790-0129PK, 790-0116PK, 790-0120PK, 790-0116QR, 790-0129QR, 790-0120QR
Scrip Part Number(s): 796 0024, 796 0022, 796 0023, 796 0018, 796 0020, 796 0019