Get the free Professional Claim (CMS-1500) Field Descriptions

Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. Professional Claim (CMS1500) Field Descriptions Following are Kaiser Foundation Health Plan

How to fill out professional claim cms-1500 field

How to fill out professional claim cms-1500 field

1. To fill out the professional claim CMS-1500 field, follow these steps:
2. Start with the patient's information. Enter the patient's name, address, gender, and date of birth in the indicated fields.
3. In the next section, provide the insurance information. Enter the name of the primary insurance, policy number, group number, and the patient's relationship to the insured.
4. Include the date of the current illness, injury, or pregnancy (if applicable) in the corresponding field.
5. Use the diagnosis code pointers to link the procedures performed to the appropriate diagnosis code. These pointers help identify the medical necessity for the services rendered.
6. Enter the date of service for each procedure performed, along with the corresponding procedure code and modifier (if applicable). Include the number of units or hours for each service.
7. Specify the charges for each procedure by entering the billed amount.
8. If there are any prior payments or adjustments, include the details in the appropriate fields.
9. Finally, sign and date the form to certify the accuracy of the information provided. Include the provider's name, address, and NPI (National Provider Identifier) number.
10. Remember to double-check all the information before submitting the claim.

Who needs professional claim cms-1500 field?

1. Anyone who provides professional healthcare services and wishes to receive reimbursement from insurance companies may need to fill out the professional claim CMS-1500 field.
2. This form is commonly used by healthcare providers such as physicians, surgeons, psychologists, chiropractors, physical therapists, and other qualified healthcare professionals.
3. It is also used by healthcare facilities, clinics, and billing companies that handle the billing and claims submission process on behalf of the healthcare providers.
4. The professional claim CMS-1500 field is necessary when seeking reimbursement for healthcare services covered by private health insurance, Medicare, or Medicaid.

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What is professional claim cms-1500 field?

The professional claim CMS-1500 field is a section on the CMS-1500 form where healthcare providers enter information about the services provided to a patient.

Who is required to file professional claim cms-1500 field?

Healthcare providers, such as physicians, hospitals, and clinics, are required to file the professional claim CMS-1500 field.

How to fill out professional claim cms-1500 field?

Healthcare providers must accurately enter information such as patient demographics, diagnosis codes, procedure codes, and other relevant details on the professional claim CMS-1500 field.

What is the purpose of professional claim cms-1500 field?

The purpose of the professional claim CMS-1500 field is to bill insurance companies for the services provided to a patient.

What information must be reported on professional claim cms-1500 field?

Information such as patient demographics, insurance information, diagnosis codes, procedure codes, dates of service, and other relevant details must be reported on the professional claim CMS-1500 field.