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New 1500 Claim Form Approved
to
Accommodate
ICD9
or
ICD10 Diagnosis Codes
On June 17, 2013, the National Uniform Claim Committee (NCC)
announced the approval of Version 02/12 1500 Health Insurance
Claim
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How to fill out new 1500 claim form
How to fill out new 1500 claim form
01
To fill out the new 1500 claim form, follow these steps:
02
Start by entering the patient's personal information, such as their name, address, and contact details.
03
Next, provide the patient's insurance information, including policy number and group number.
04
Indicate the type of insurance plan the patient has, whether it's Medicare, Medicaid, or private insurance.
05
Fill in the physician or healthcare provider's information, including their name, address, and National Provider Identifier (NPI) number.
06
Provide the details of the services rendered, including the date of service, the procedure or treatment provided, and any applicable CPT or HCPCS codes.
07
Include any supporting documentation, such as medical records or a referral form, if required.
08
Double-check all the information entered to ensure its accuracy.
09
Sign and date the form to certify its completeness and correctness.
10
Finally, submit the completed form to the appropriate insurance carrier or payer for processing.
Who needs new 1500 claim form?
01
Various healthcare providers, including physicians, hospitals, clinics, and other healthcare facilities, need to use the new 1500 claim form. Additionally, insurance companies and third-party payers require this form to process claims for reimbursement. Patients who want to submit claims for healthcare services may also need to fill out this form.
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