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How to Reimburse the Medical Expenses with CMS 1500 Form

CMS 1500: Health Insurance Claim Form

The health insurance system of the USA consists of programs that help individuals pay for medical services provided during their stay in the hospital. This program can be private or funded by the government. The two most well known government insurance programs are Medicare and Medicaid. Actually, these are the basic insurance programs for the USA residents without any health insurance. With time, however, these programs became the standard for health insurance providers. The main point of any insurance program is to return the money spent on medical services. The patient in the hospital shows his health insurance policy to the physician, allowing medical coverage to be provided. After this, the health care provider should take the matter into his own hands. The first step for doing this is to gather all the required information about the medical charges is dealt with. The Centers for Medicare and Medicaid Services have a special document for this purpose – the CMS 1500 form 2015. Read below to learn more.

Who needs a CMS 1500 form 2015?

The Health Insurance Claim form is used by the health care providers to claim for the reimbursement for the services provided to the patients from the government health insurance programs. This form is issued by the Centers for Medicare and Medicaid Services.

What is the purpose of the CMS 1500 form 2015?

This claim form is required to receive payments from the Medicare and Medicaid carriers for the provided services. The physicians and sometimes private insurers complete the claim, indicating the information about the patience and his condition, medical services, and the insurance details.

What other documents must accompany the CMS 1500 form 2015?

Usually, this claim form doesn’t need to be supported by other documents.

When is the CMS 1500 form 2015 due?

The health care provider must file the claim form during the year after the medical services were provided.

What sections should be filled out in the CMS 1500 form 2015?

The physician or other authorized people must add the following details:

  • Type of the insurance (Medicare, Medicaid, Tricare, or other);
  • Information about the patient and the insured (name, address, birth date, sex, insured’s ID number, account number);
  • Information about the insurance (policy group, plan name or program name, health benefits name);
  • Information about the illness (date of the illness, injury or pregnancy, dates of the patient unable to work, hospitalization date, diagnosis or nature of illness or injury);
  • Information about the health care provider (name or referring provider or other sources);
  • Information about the medical services (dates, place, description of procedures, services, or supplies, charges);
  • Federal Tax ID number.

The Health Insurance Claim form must be signed by the patient or insured person and by the physician as well (including degrees or credentials).

Where the CMS 1500 form 2015 should be sent?

The completed claim form is forwarded to the Centers of Medicare carriers.