Medical Forms, Health Insurance Claim Forms, CMS1500, UB92, Hospital Claim Forms

Insurance Claim Forms: CMS1500

Insurance Claim Forms


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 claims. It is also used for billing of some Medicaid State Agencies.


The only acceptable claim forms are those printed in Flint OCR Red. Although a copy of the CMS-1500 form can be downloaded, copies of the form cannot be used for submission of claims, since your copy may not accurately replicate the scale and OCR color of the form. The majority of paper claims sent to carriers and DMERCs are scanned using Optical Character Recognition (OCR) technology. This scanning technology allows for the data contents contained on the form to be read while the actual form fields, headings, and lines remain invisible to the scanner. Photocopies cannot be scanned and therefore are not accepted by all carriers and DMERCs.


medical-forms.com offers the latest version of the Insurance Claim Forms CMS-1500 approved by the Centers for Medicare & Medicaid Services (CMS). We have 10 warehouses located nationwide for low cost and quick delivery.


 


CMS1500 -1 Part Continuous Feed

Insurance Claim Forms: 2 Part Hand-written

View Sample
PDF
CMS1500 Laser & Ink-jet

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