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  Medical insurance claim forms

Now Available

cms 1500 book   ub04 book

Detailed instructions on
completing a
CMS 1500 and UB04 form

Medical Insurance Claim Forms

     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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