CMS 1500 Claim Forms
Product Overview
Cmfi Group CMS 1500 Claim Forms
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"
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Cmfi Group CMS 1500 Claim Forms
CMS 1500 Claim Forms Reviews Summary
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CMS 1500 Claim Forms
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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
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