HCFA/CMS 1500 Reference Guide
Index
- Sections
- CARRIER
- PATIENT AND INSURANCE INFORMATION (From Box 1 to 13)
- 1. Insurance: Patient Demographics > Insurance Info
In this knowledge base article, we provide a reference guide to the Health Insurance Claim Form 1500. This guide is intended to help you understand what each field on the form represents and where to source the required information.
By breaking down the form section by section, you'll gain clarity on how to accurately complete it and ensure consistency in data entry across submissions.
CARRIER
Settings & Directories > Group Level Settings > Insur Payers.
PATIENT AND INSURANCE INFORMATION (From Box 1 to 13)
1. Insurance: Patient Demographics > Insurance Info
1a. Insured’s ID #: Patient Demographics > Insurance Info
2. Patient’s Name: Patient Demographics
3. Patient DOB: Patient Demographics
4. Insured’s Name: Patient Demographics > Insurance Info
5. Patient’s Address: Patient Demographics
6. Patient Relationship to Insured: Patient Demographics
7. Insured’s Address: Patient Demographics > Insurance Info
8. Reserved for NUCC use.
9. Other Insured’s Name: Patient Demographics > Insurance Info > Insured Party
9a. Other Insured’s Policy or Group #: Patient Demographics > Insurance Info > Secondary Insurance
9b. Reserved for NUCC use.
9c. Reserved for NUCC use.
9d. Insurance Plan Name of Program Name: Patient Demographics > Insurance Info > Secondary Insurance
10. Is Patient’s Condition Related To:
Related Articles
Printing a HCFA/CMS 1500 Form
To print a HCFA/CMS 1500 form for an encounter, first, open the "Reports" drop-down menu on the top-left of your screen and select the "Billing/Productivity Report." Enter the filter criteria needed to capture the encounter(s) you want to print and ...UB-04 Guide
Index Sections UB-04 Guide I. Settings & Directories A. Group Level Settings 1. Sites/Letterheads B. Specific to Individual Level Settings 2. Billing Rates & Payer Rules II. Patient Demographics A. Patient Info B. Insurance Info III. Patient Accounts ...Claim Note Reference Code and Claim Note Text
A new tab (Additional Info) has been added to the Insurance Information section of Demographics with options for Claim Note Reference Code and Claim Note Text. These fields are to be used for additional claim information contained in the Service Loop ...Claim Resubmission Code and Original Reference Number
The ability to re-submit claims is available within the Billing/Productivity Report. Use the Billing/Productivity report to locate any claims that need to be updated, make the needed changes, then use the workflow below to submit the updated claims. ...Manual Post Payments for Secondary Billing
This Knowledge Base guide covers the workflow for using Manual Post Payments in Patient Accounts to manually post an insurance payment – as opposed to auto post – for the purposes of electronically billing the secondary payer. Please note, if your ...