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MMS Replacement Project (MRP) State of Mississippi, Office of the Governor, Division of Medicaid (DOM)Paper Claims Billing Instructions Version 5.0Change History The following change history log contains

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How to fill out paper claims billing instructions

01

Obtain the paper claims form from the insurance company or download it from their website.

02

Read the instructions carefully to understand what information needs to be provided on the form.

03

Fill in the patient's demographic information, insurance policy details, and provider information accurately.

04

Include the diagnosis and procedure codes for the services rendered.

05

Attach any required supporting documentation, such as medical records or referral forms.

06

Review the completed form for accuracy and completeness before submitting it to the insurance company.

Who needs paper claims billing instructions?

01

Healthcare providers who do not have access to electronic claims submission systems.

02

Patients who receive services from providers who only accept paper claims.

03

Insurance companies that require paper documentation for claims processing.

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What is paper claims billing instructions?

Paper claims billing instructions provide detailed guidelines and requirements for submitting healthcare claims in a printed format.

Who is required to file paper claims billing instructions?

Healthcare providers and professionals who are not able to submit claims electronically are required to file paper claims billing instructions.

How to fill out paper claims billing instructions?

Paper claims billing instructions must be filled out accurately with all the necessary patient information, diagnosis codes, procedure codes, and provider details.

What is the purpose of paper claims billing instructions?

The purpose of paper claims billing instructions is to ensure that healthcare claims are submitted correctly and in compliance with billing regulations.

What information must be reported on paper claims billing instructions?

Paper claims billing instructions must include patient demographics, provider information, diagnosis codes, procedure codes, and any other relevant details for billing purposes.

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