Get Chapter 11 - Essential CMS-1500 Claim Instructions Flashcards ...

item 11. Enter the nine-digit PAYERID number of the primary insurer. If no PAYERID number exists, then enter the complete primary payer's program or plan name. If the primary payer's EOB does not contain the claims processing address, record the primary payer's claims processing address directly on the EOB.

12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE I authorize the release of any medical or other information necessary to process this claim.

How to fill out a CMS-1500 form The type of insurance and the insured's ID number. The patient's full name. The patient's date of birth. The insured's full name, if applicable. The patient's address. The patient's relationship to the insured, if applicable. The insured's address, if applicable. Field reserved for NUCC use.

If there is insurance primary to Medicare, the insured's policy or group number must be entered in item 11. Also, 11a - 11c, 4, 6, 7 and 10 must also be completed. If there is no insurance primary to Medicare, the word "none" should be entered in block 11.

Box 11c is the name of the insurance plan or program of the insured. Some payers require an identification number rather than the name in this field.

Common Mistakes on the CMS 1500 Claim Form Mistake 1: Using an Outdated Form. Mistake 2: Diagnosis Code Isn't Specific Enough. Mistake 3: CPT Code Isn't Accurate. Mistake 4: Misusing CPT Codes. Mistake 5: Claim Wasn't Filed on Time. Mistake 6: Claim is Missing Information or Using Inaccurate Information.

If there is insurance primary to Medicare, the insured's policy or group number must be entered in item 11. Also, 11a - 11c, 4, 6, 7 and 10 must also be completed. If there is no insurance primary to Medicare, the word "none" should be entered in block 11.

item 11. Enter the nine-digit PAYERID number of the primary insurer. If no PAYERID number exists, then enter the complete primary payer's program or plan name. If the primary payer's EOB does not contain the claims processing address, record the primary payer's claims processing address directly on the EOB.