Get the free Medicaid Clean Claim Report (FIS 0278)

FIS 0278 (2/17) Department of Insurance and Financial ServicesProvider Tax ID number (FEIN)Medicaid Clean Claim ReportYou may file this report for an individual claim if it is a payable clean claim.Providers

How to fill out medicaid clean claim report

How to fill out medicaid clean claim report

1. Gather necessary patient information: Obtain the patient's full name, address, date of birth, and Medicaid identification number.
2. Collect provider details: Include the healthcare provider's name, National Provider Identifier (NPI), and contact information.
3. Document service details: Clearly outline the dates of service, types of procedures performed, and relevant diagnosis codes using the appropriate ICD codes.
4. Ensure all claim forms are complete: Fill out the required forms accurately, including any additional documentation that may be needed.
5. Verify billing codes: Use the correct CPT codes for the services rendered to ensure accurate billing.
6. Review for accuracy: Double-check all information for errors, ensuring that there are no missing fields or incorrect codes.
7. Submit the claim: Send the completed Medicaid clean claim report electronically or via mail according to your local Medicaid office's guidelines.

Who needs medicaid clean claim report?

1. Healthcare providers seeking reimbursement for services provided to Medicaid beneficiaries.
2. Patients who require coverage for their medical expenses through Medicaid.
3. Insurance companies that process claims on behalf of Medicaid providers.
4. State Medicaid agencies that review and approve claims for reimbursement.

For pdfFiller’s FAQs

How can I send medicaid clean claim report for eSignature?

Once your medicaid clean claim report is complete, you can securely share it with recipients and gather eSignatures with pdfFiller in just a few clicks. You may transmit a PDF by email, text message, fax, USPS mail, or online notarization directly from your account. Make an account right now and give it a go.

How do I edit medicaid clean claim report on an iOS device?

Create, modify, and share medicaid clean claim report using the pdfFiller iOS app. Easy to install from the Apple Store. You may sign up for a free trial and then purchase a membership.

Can I edit medicaid clean claim report on an Android device?

You can. With the pdfFiller Android app, you can edit, sign, and distribute medicaid clean claim report from anywhere with an internet connection. Take use of the app's mobile capabilities.

What is medicaid clean claim report?

A Medicaid clean claim report is a submission of a claim for reimbursement for medical services that has no deficiencies or errors and meets all requirements for processing according to Medicaid guidelines.

Who is required to file medicaid clean claim report?

Healthcare providers who offer services covered by Medicaid and wish to receive reimbursement for those services are required to file a Medicaid clean claim report.

How to fill out medicaid clean claim report?

To fill out a Medicaid clean claim report, providers should ensure all required fields are accurately completed, including patient information, service details, provider credentials, and any relevant supporting documentation, while following the specific guidelines set by their state's Medicaid program.

What is the purpose of medicaid clean claim report?

The purpose of a Medicaid clean claim report is to simplify the billing process by ensuring that claims are filed correctly and efficiently which facilitates timely payment and reduces the chances of claim denials or delays.

What information must be reported on medicaid clean claim report?

A Medicaid clean claim report must include patient demographics, provider information, details of services provided, diagnosis codes, procedure codes, and any required supporting documentation.