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HCFA 1500

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HCFA 1500
Managed care The official standard form used by physicians and other providers when submitting bills/claims for reimbursement to Medicare or Medicaid for health services; it is also used by private insurers and managed care plans; HCFA 1500 contains Pt demographics, diagnostic codes, CPT/HCPCS codes, diagnosis codes, units. See Compliance, HCFA, Medicare, Red tape. Cf UB92.


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I recently received a letter from an insurance company advising me that, to process my client's injury claim, the insurer would "require UB-92 forms for hospital care and HCFA 1500 forms for any other medical care.
The billing process begins with a download of data from the provider's information system, usually in the form of a print spool file containing the UB-92 or HCFA 1500 claims, and then the billing application analyzes each claim for completeness and accuracy of data.
 
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