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Get *revised - Npi Cms 1500 (version 08/05) Paper ... - Anthem
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How to fill out the *REVISED - NPI CMS 1500 (version 08/05) Paper Claims Form online
The *REVISED - NPI CMS 1500 (version 08/05) Paper Claims Form is essential for providers submitting claims to Anthem Blue Cross and Blue Shield. This guide provides a detailed, step-by-step process for accurately completing the form online.
Follow the steps to effectively complete the form.
- Click the ‘Get Form’ button to access the *REVISED - NPI CMS 1500 form and open it in your preferred editing tool.
- Begin completing the personal and professional information in the appropriate fields, including the Provider Identification Number (PIN) and National Provider Identifier (NPI). Ensure that all entries are correct and confirm that you are using the latest version of the form.
- Fill in the required sections such as patient information and the health care services provided. Pay particular attention to field 17b where you should enter the referring provider's NPI.
- Complete field 19 with the referring provider qualifier and taxonomy if applicable. It is strongly advised to report the taxonomy code to accurately reflect the specialty of the provider.
- In fields 24J shaded and unshaded, enter the appropriate provider ID information including the Anthem Legacy Provider ID and the NPI. Ensure correct entry format as specified.
- Review all sections carefully, especially field 32, which should reflect the service facility name and address, along with any necessary NPI data.
- Finalize your form by checking all required fields are completed accurately. Proceed to save your changes, then download, print, or share the filled form as needed.
Complete your *REVISED - NPI CMS 1500 form online today for efficient claims processing.
To fill out a health insurance claim form properly, start with accurate patient and provider information. Each box must be completed as per the specifications of the CMS 1500 guidelines, including the inclusion of the NPI number and service details. Verify all details before submission to prevent payment delays. Uslegalforms provides templates and instructions that can simplify this process.
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