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What Is CMS 1500

What Is CMS 1500 Finance

CMS 1500, the standard health insurance billing form developed by the Center for Medicare Services & Medicaid Services (CMS), for all claims made by health care service providers for professional medical services rendered by them, is designed by The National Uniform Claim Committee (NUCC). Apart from Medicare, the CMS 1500 form is also used for billing by various government and private insurers too.

While the form is not directly sent by the CMS to the providers of medical services, it can be obtained from the United States Government Printing Office, local printing companies or the office supply stores in neighboring localities for a fee. It can be bought as a single part, multi-part, continuous feed, laser, etc, in several different arrangements. Photocopies of the forms are not accepted for processing claims, and only printed forms are generally recognized. The scale and OCR color (Flint OCR Red, J6983) of the form is of great significance in order to not be delayed or denied payment, because these are essential to enable the automated reading of information on the submitted form. Hence scanned copies of the paper claim forms, CMS 1500, using only the Optical Character Recognition (OCR) technology are agreed upon for usage. Since the data elements in both the electronic and paper forms are identical, one processing system handles both efficiently.

The CMS 1500 is the standard paper claim form used for billing Medicare Fee-For-Service (FFS) Contractors when a paper claim is permitted. The filing period for the CMS 1500 paper claim is 12 months after the date of service. However, Medicare allows exceptions to this 12-month time frame. The CMS 1500 is used for compensation from various government insurance plans such as Medicare, Medicaid, and such companies. The CMS 1500 is an important document because it is used for billing medical claims by physicians, their assistants, nurses, midwives, clinical psychologists and clinical social workers, ambulance services, diagnostic lab services and many others. Instructions for completing the CMS 1500 form must be read thoroughly before it is filled for claiming reimbursements.

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