CMS-1500 or HCFA 1500 Claim Template
The medical billing industry isn’t so much complex as it is important to understand what health insurance carriers require in order to pay on an outstanding medical claim. The medical claim template allows a medical office to create and default claim templates to health insurance carriers within the practice management software.
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Medicare sets the claim standards within the industry however; any insurance carrier can ignore these rules and make up their own medical claim requirements. Your standard health insurance carriers like Aetna, Cigna, United Health Care, Humana, Blue Cross Blue Shield will normally follow Medicare’s guidelines but other insurance carriers especially auto insurance and smaller health insurance carriers can and normally do request different information to be formatted to the medical claim.
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As medical offices communicate with health insurance carriers and identify what is required on the medical claim they can go into the claim template screen and default the claim template any way they need it to reflect. They attach the medical claim template to the health insurance carrier within the practice management software and then attach the insurance carrier to the patient records in the insurance tab. When the medical claim generates it will pull to this claim template and automatically attach all of the patient’s medical records to the medical claim in the right fields.
To learn more about CMS-1500 or HCFA 1500 Claim Template setup please Watch our FREE Medical training video series.
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