CMS-1500

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CMS-1500

The uniform professional health care insurance claim form in the U.S. Previously known as the HCFA-1500 claim form.
Synonym(s): HCFA-1500, Health Insurance Claim Form.
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The solution supports both HCFA-1500 and UB-04 Claims on a single product.
Replacing manual data entry of standardized healthcare information forms such as HCFA-1500 and UB-92 with paper-to-digital processing, it automates the management of forms and documents to improve medical claims' throughput and productivity rates.
He noted that the types of things likely to be included in the documentation criteria include "all the information used in an HCFA-1500 [Health Care Financing Administration] form when claims are submitted, such as the patient's name, provider's name, CPT code and the DSM or ICD-9 code, and one or two additional elements which we're still discussing.
In defining service measures, data from UB92 claim forms, which are typically used to bill for institutional services, were combined with data from HCFA-1500 forms, which are typically used to bill for non-institutional services.
5 will accommodate government mandated revisions to the HCFA-1500 claim form, the newly approved UB-04 claim form, support of X12 electronic billing for institutional claims and other enhancements.
Just by scanning the custom designed super bill, AutoMed can -- Submit HCFA-1500 (medical service billing form) and Ub92 (hospital or facility billing form) claims electronically and post electronic payments automatically.
There also is no way to code multiaxial diagnoses on the HCFA-1500.
Processing time for HCFA-1500 forms (an industry-standard claim submission form) took about a week.
In addition to the standardization that will probably result from the McData effort, several States and HCFA have built on the efforts of the National Uniform Claim Form Committee, which developed the HCFA-1500 billing form for ambulatory services, and the National Uniform Billing Committee, which developed the UB92 hospital billing form, as well as the American National Standards Institute (ANSI), which has developed standards for electronic submission of the HCFA-1500 and UB92 forms.
The new version helps hospitals seamlessly transition from the current UB-92 and HCFA-1500 claim forms to the new UB-04 and CMS-1500 claim forms for enhanced claim adjudication.
Our secondary claims software product has traditionally resided on the provider's computer system, and seamlessly integrates with their practice management software to simultaneously produce an electronic file of HCFA-1500 formatted secondary claims and corresponding single-patient explanation of benefits (EOB's).
While it would be an uphill battle to redesign the HCFA-1500 or UB-92, there are plenty of forms that enter the claims processing paper stream that can be redesigned.