Fillable Instructions on how to fill out the CMS 1500 Form - L.A. Care Health ... - lacare
Instructions on how to fill out the CMS 1500 Form
Item Item 1 Instructions Type of Health Insurance Coverage Applicable to the Claim Show the type of health insurance coverage applicable to this claim by checking the appropriate box, e.g., if a Medicare claim is being filed, check the Medicare box. Insured's ID Number (Patient's Medicare Health Insurance Claim Number - HICN) This is a required field. Enter the...
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