Where Do I Send My 1500 Insurance Form

The nucc does not process claims.

Where do i send my 1500 insurance form. Expiration date of 2020 03 31 pending o m b. The current version of the instructions for the 02 12 1500 claim form was released in july 2020. Send all forms for feca to u s department of labor owcp dfec p o. Once you ve filled out the cms 1500 claim form simply send it to the insurance company listed on the top of the page.

Version 8 0 7 20 1500 instruction manual. How to submit claims. However claims do need to contain the correct billing code to help us identify when a claim is being submitted to correct or void a claim that we ve previously processed. The necessary fields outlined below for medicare secondary payer msp must be completed.

You can also send multiple claims for different patients to the same insurance at the same time. The cms 1500 claim form is currently the only accepted form for submitting paper claims to both government and commercial health insurance carriers. Complete the items below on the cms 1500 02 12 claim form or electronic equivalent in addition to all other claim form requirements when medicare is the secondary payer. 34297 san antonio tx 78265 unless otherwise instructed.

Do not email fax or mail completed 1500 claim forms to the nucc. Download the fillable hcfa 1500 claim form that is both a fillable and or printable medical claim form that will provide insurance illness and injury information for medical services claims if the user would like to complete the form online simply download click inside the box to begin and begin typing your information. How to complete the cms 1500 claim form dhs choices waiver providers effective december 1 2016 rev. It is printed in red ink as shown on the right.

The only forms accepted are the official forms printed in flint ocr red j6983 ink. Send completed forms to the appropriate payer. Cms 1500 02 12 claim form instructions when medicare is secondary. Send all forms for blba to u s department of labor owcp dcmwc p o.

12 19 16 the following is a step by step explanation of how to prepare the health insurance claim form cms 1500. Failure to properly complete mandatory requirements will cause the claim to be denied by south dakota medicaid. 1500 instruction manual changes. If your claim is more than one page then send all the pages together at the same time.

Claims may be electronically submitted to a medicare carrier durable medical equipment medicare administrative contractor dmemac or a b mac from a provider s office using a computer with software that meets electronic filing requirements as established by the hipaa claim standard and by meeting cms requirements contained in the provider enrollment certification.