Get General Instructions For Dhs 8015

Filling out the General Instructions for DHS 8015 is a crucial step in submitting your CMS 1500 claim form. This guide provides clear and concise instructions to help you complete the form accurately, ensuring compliance with all requirements.

Follow the steps to accurately complete the DHS 8015 form.

1. Click 'Get Form' button to obtain the form and open it for editing.
2. Section: Patient Information. Fill in the date of the screening visit, making sure it matches the date of service on the CMS 1500 claim form.
3. If the patient's age on the exam date is not aligned with the listed age in the column, indicate the appropriate EPSDT periodic screening age being reported, usually selecting the age range directly below the child’s actual age.
4. Section: Measurements. Record the patient's height and weight in pounds and inches, and calculate BMI and BMI% for children aged 2-20 years, using an online BMI calculator.
5. Section: Immunizations Given Today. Fill in the circles next to all immunizations administered during the visit and indicate their status (up to date, catch-up scheduled, refused, or contraindicated). This section must not be left blank.
6. Section: Screening Done Today. Document the results of the vision screening, audiometry testing, developmental screening, and autism screening, as well as record if a blood lead level and Hgb/Hct blood level were ordered.
7. Section: Referrals Made Today. Indicate the appropriate circles for referrals made and list the programs or specialties along with a contact number for follow-up.
8. Section: Care Coordination Assistance Needed. Indicate if assistance is needed by checking the appropriate circle and record the contact phone number of the patient, parent, or caregiver if applicable.
9. Section: Provider Statement. Make sure the provider's signature and NPI number are completed, as this section is necessary for the form to be considered complete.
10. Finally, after filling out all sections, save your changes, download, print, or share the DHS 8015 form as needed.

Be sure to complete and submit your DHS 8015 form online to ensure a smooth claims process.