HCFA 1500 Form Explained (2024)

FAQs

HCFA 1500 Form Explained? ›

The Form HCFA-1500 answers the needs of many health insurers. It is the basic form prescribed by HCFA for the Medicare program for claims from physicians and suppliers, except for ambulance services.

The HCFA 1500 claim form, also known as CMS-1500, enables medical physicians to submit health insurance claims for reimbursem*nt from various government insurance plans including Medicare, Medicaid and Tricare.

The Health Insurance Claim Form (CMS-1500) is used by Allied Health professionals, physicians, laboratories and pharmacies to bill supplies and services to the Medi-Cal program. Providers are required to purchase CMS-1500 claim forms from a vendor.

H. The number in Box 26 is your claim number. I. Box 27 of this form is called the assignment indicator. If this box is marked “Yes,” Mayo Clinic expects your supplemental insurance company to pay Mayo directly. This does not mean that Mayo will accept the insurance payment as payment in full.

The use of HCFA provides a standardized method for healthcare providers to submit claims for reimbursem*nt. This reduces the likelihood of errors and helps ensure that claims are processed on time. It also helps to ensure that claims are submitted consistently, which can help reduce the risk of fraud and abuse.

The term CMS 1500 refers to the Centers for Medicare & Medicaid Services Form 1500, while HCFA 1500 is an older term that stands for Health Care Financing Administration Form 1500. The HCFA was renamed CMS in the year 2001, but the term HCFA 1500 is still widely accepted and used in the industry.

The CMS-1500 form is the standard claim form used by a non-institutional provider or supplier to bill Medicare carriers and durable medical equipment regional carriers (DMERCs) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of ...

Address common patient complaints such as long wait times, slow response times, lack of provider availability, and more. Give patients ample face-to-face time with providers during appointments so they don't feel rushed.

What does HCFA stand for? ›

The Health Care Financing Administration (HCFA) was created in 1977 to combine under one administration the oversight of the Medicare program, the Federal portion of the Medicaid program, and related quality assurance activities.

The Health Care Financing Administration (HCFA) form, also known as the CMS-1500 form, is a standardized paper claim form used by health care providers to submit claims for reimbursem*nt of medical services provided to patients. It is used primarily for billing Medicare, Medicaid, and private insurance companies.

Copies, handwritten claims, and other claim form types will be rejected. printing requirements will be rejected back to the provider or facility upon receipt. ink.

33 Required Billing Provider Info & Phone # (Pay-To) - Enter the provider name. Enter the provider address, without a comma between the city and state, and a nine-digit zip code, without a hyphen. Enter the telephone number. 33a Required Billing Provider Info & Phone # (Pay-To, NPI) - Enter the billing provider's NPI.

From the Basic tab enter the name in the Facility Name field and the service location address. The name and address entered will appear in Box 32 on the HCFA 1500 form.

Box 14 - Date of Current Illness, Injury, or Pregnancy (LMP)

Enter the applicable qualifier to identify which date is being reported.

Subscribe. The Health Care Financing Administration (HCFA) was created in 1977 to combine under one administration the oversight of the Medicare program, the Federal portion of the Medicaid program, and related quality assurance activities.

Billing Provider Information & Phone Number – name, address, and phone number of provider requesting to be paid for services rendered. Billing provider address on both a CMS 1500 and UB must be the physical location; not a PO Box.

Centers for Medicare and Medicaid Services, formerly known as the Health Care Financing Administration.

Number. This Federal Tax I.D. number will be placed in Box 25 of the CMS 1500 form.