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Delete Number Fields from the Accident Medical Claim Form

Delete Number Fields from the Accident Medical Claim Form

Aug 6th, 2022

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How to Delete Number Fields from the Accident Medical Claim Form

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Getting back to work promptly can significantly aid injured workers' recovery in Washington State. After an on-the-job injury, workers collaborate with medical providers to complete a Report of Accident (ROA) for the Washington State Department of Labor and Industries (LI). Filing the ROA manually via mail or fax can lead to service and benefit delays, with LI receiving around 90,000 pages daily. Complications such as incomplete forms or poor quality submissions can further prolong processing times, thereby affecting workers' recovery and impacting their families and employers. Utilizing the online platform FileFast can expedite claim processing by at least a notable margin.

Got questions?

Below are some common questions from our customers that may provide you with the answer you're looking for. If you can't find an answer to your question, please don't hesitate to reach out to us.

What is field 23 in CMS 1500 claim form?

Box 23 is used to show the payer assigned number authorizing the service(s).

Can you edit an insurance claim?

Make Changes, Add Reference/Resubmission Numbers, and Then Resubmit: To resolve a claim problem, typically you will edit the charges or the patient record, add the payer claim control number, and then resubmit or rebatch the claim.

What is box 14 on the CMS 1500 claim form?

Box 14 - Date of Current Illness, Injury, or Pregnancy (LMP) Enter the applicable qualifier to identify which date is being reported.

What goes in box 23 on the CMS 1500 form?

Box 23 - TITLE: Prior Authorization Number (this field is also used for CLIA numbers) INSTRUCTIONS: Enter any of the following: prior authorization number, referral number, or Clinical Laboratory Improvement Amendments (CLIA) number, as assigned by the payer for the current service.

What is field 24 in CMS 1500 claim form?

A Place of Service (POS) is a field used when completing a CMS 1500 form to submit a claim to insurance. It indicates the location in which the health care service is actually provided.

What is box 15 on a HCFA 1500 form?

A point of origin code discloses to the payer the source or method of the patients referral for admission. The point of origin code is similar to a place of service code on a professional claim/HCFA-1500 form.

What is field 22 in CMS 1500 claim form?

Complete box 22 (Resubmission Code) to include a 7 (the Replace billing code) to notify us of a corrected or replacement claim, or insert an 8 (the Void billing code) to let us know you are voiding a previously submitted claim. Enter the Blue Cross NC original claim number as the Original Ref.

What fields are on a CMS 1500 form?

Field by Field Explanation Of The CMS-1500 Form a. PATIENT NAME from Patient Master. Patient DOB and SEX from Patient Master. Name of the INSURED PERSON of the destination payer in Insurance Information screen under Patient Master. PATIENT ADDRESS, CITY, STATE, ZIP CODE HOME PHONE from Patient Master.

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