Highmark BCBS CLM-038 2000 free printable template

MEDICAL CLAIM FORM P.O. Box 1210 Pittsburgh, PA 15230 An Independent Licensee of the Blue Cross and Blue Shield Association TO BE COMPLETED BY EMPLOYEE INFORMATION: 1. EMPLOYEE'S NAME (LAST) (FIRST)

How to fill out Highmark BCBS CLM-038

How to fill out Highmark BCBS CLM-038

1. Ensure you have the CLM-038 form printed or available electronically.
2. Begin by filling out the patient’s identification information at the top of the form.
3. Enter the date of service in the designated field.
4. Provide the patient's insurance information, including the policy number and group number.
5. Indicate the type of service provided using the appropriate codes.
6. Fill in the billing provider's information, including name, address, and tax ID.
7. Include the total charge for the services rendered in the appropriate section.
8. Sign and date the form to certify that the information is accurate.

Who needs Highmark BCBS CLM-038?

1. Insurance providers requiring documentation for claims processing.
2. Healthcare providers submitting claims for reimbursement.
3. Patients needing coverage for medical services through their Highmark BCBS plan.

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What is Highmark BCBS CLM-038?

Highmark BCBS CLM-038 is a claim form used by healthcare providers to submit claims for reimbursement of services rendered to patients covered by Highmark Blue Cross Blue Shield.

Who is required to file Highmark BCBS CLM-038?

Healthcare providers, including physicians, hospitals, and other medical facilities that provide services to patients enrolled in Highmark Blue Cross Blue Shield plans, are required to file Highmark BCBS CLM-038.

How to fill out Highmark BCBS CLM-038?

To fill out Highmark BCBS CLM-038, providers must complete sections including patient information, provider details, service dates, procedure codes, and billing amounts, ensuring accuracy and compliance with Highmark guidelines.

What is the purpose of Highmark BCBS CLM-038?

The purpose of Highmark BCBS CLM-038 is to facilitate the processing and reimbursement of healthcare claims submitted by providers for services rendered to patients.

What information must be reported on Highmark BCBS CLM-038?

The information that must be reported on Highmark BCBS CLM-038 includes patient demographics, provider information, details of the services provided, diagnosis codes, and the costs associated with the services.