When submitting medical
insurance claim forms to the insurance
companies, it is important to file the claims on the appropriate forms. The
most common medical insurance form used in most provider's offices is the
HCFA or CMS 1500. It is printed on white paper with red ink and
must be completed in black or dark blue ink.
It is crucial that the fields
on the HCFA form are filled out accurately and
completely.
If any information is missing or incorrect it can cause the
entire claim to be denied. In some cases they will return the incomplete
or inaccurate claim with an explanation as to why it is not being paid.
Other times, you just don't hear anything. Did they end up with your socks
that never returned from the dryer?
Here's more information on
detailed HCFA or
CMS 1500 instructions. Make sure you are submitting these
forms correctly and completely. Denials for missing information cost
money and disrupt your cash flow.
There are some instances that a HCFA
wouldn't be used. If the claim is for an on the job injury, or a workers
compensation claim, then a workers
compensation form would
be used. These forms vary from state to state, but can usually be found on
the states workers compensation website. Here is more information of
workers comp claim forms.
In
many states forms can be downloaded and printed or purchased in quantity
by private suppliers. Some medical billing software comes with the
capability of printing the workers compensation forms. The workers
compensation forms are white with black print and have fields similar to
the HCFA 1500 form. As with the HCFA 1500, it is important that these
fields are filled out accurately and completely.
Facilities such as hospitals, outpatient clinics, and ambulatory surgery
centers use a UB04 form.
(The UB04 form replaces the older version UB92 form.)
It is the facility version of the HCFA 1500. UB04 forms are also white
with red ink, but the fields are different. Rev codes, value codes,
and type of bill are fields not found on the CMS 1500 but are required on
the UB04 form. You can find more information here on completing the UB04 form
correctly.
When
claims are submitted electronically, no medical insurance claim forms are
needed as the claims are not ever printed to paper. The claims are
actually put into the correct format and sent on to the insurance
companies in a file. The claims can either be sent via the internet, or
thru the phone lines.
HCFA and UB04 forms can be
purchased from a variety of suppliers and they vary greatly in price. The
higher the quantity purchased, the lower the price per form. Shop around
to find the best buy when looking for medical insurance claim forms.
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Medical Insurance Claim Forms.
