Most offices submit electronic claims, but there are still small offices that submit paper claims and other times when a paper claim is simply the easiest way to go. All providers should now have their NPIs. but because some payers still require alternate ID's such as license numbers or taxonomy, numbers, the current CMS 1500 claim form contains spaces for the NPI and an alternate. You will know if you have the correct edition of the 1500 form if at the top of the form, it states, “Approved by National Uniform Claim Committee (NUCC) 02/12, and in the bottom right corner, “Approved OMB-0938-1197 Form 1500 (02-12).
The claim form itself is split into three sections: Fields 1-13 are for patient information; fields 14-24 are for procedural and diagnostic information related to services provided; and fields 25-33 are for servicing and billing provider information. To reinforce the concept of the three separate sections, we will be learning the information required to correctly complete the claim form based on the section requirements with questions related to what you just learned, immediately following each section, ending with two scenarios in which you will create a clean 1500 claim based on the information given. In the office situation, all information required to complete the CMS form is found in the patient’s registration form (section 1), superbill and (to verify information) in the medical chart (section 2). The provider and billing provider information will be found in your billing (or front) office (section 3).
Average Course Completion Time is 30-40 hours.
This course is pre-approved for 6 Continuing Education Units CEUs by the American Medical Billing Association
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This course is offered in real time access. If you choose to enroll for this course from here, you will be given immediate access upon payment verification. If you have any questions, please call 580 369-2700 or email us