Sunday, March 18, 2012

How to Complete a CMS 1500 Form

Preparing a claim for insurance billing is very easy but requires utmost accuracy. Even a minor error in this part will result in claim denial. Today most claims are billed electronically. Electronic billing consists of entering the billing information in to the practice management system and sending the claim electronically via EDI (electronic data interchange). The data that you enter in to the practice management software can also populate the CMS 1500 form. Although EDI and the paper form are different in many ways you cannot see, the basic premise is the same and best taught using the paper form.

You can break down the form in to three sections. At the top, you must enter the patient’s personal information, like name, date of birth, insurance information, etc.. At the bottom of the form you enter information about the visit to the provider including diagnosis, procedures, etc.. Last, there is information about the doctor who provided the services.

Here is an image of the CMS 1500 form used for medical billing:

CMS (The Centers for Medicare and Medicaid Services) provides a detailed, line by line explanation on how to complete the form. Rather than trying to retype all that info, I will provide you with the direct link to instructions on completing the form. Those instructions can be found at How toComplete a CMS 1500 Form


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