Hide SNN Field to the Claims Reporting Form

Aug 6th, 2022
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How to Hide SNN Field to the Claims Reporting Form

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so how do we partner with captives Im going to go through that in this short video this is not going to be very long and essentially you could consider this almost as an introduction to the demo that we have online at the website self insured reporting com of course if youre accessing this video video youre probably doing it from the captive section of the website but you can also simply click on demo and theres an on-demand demo now this on-demand demo was done from the perspective of why were a good fit as a platform for employed benefit brokers but I think its important obviously with you being a captive obviously to understand why thats very important of course thats a lot of your distribution and of course you can see a lot of the reasons that captives really like the things that we do but Im just going to cover just a couple of things that are unique to captives since because as a captive obviously you want to make a broker happy you want to make your distribution for so

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The two most common claim forms are the CMS-1500 and the UB-04. These two forms look and operate similarly, but they are not interchangeable.
32 Required Service Facility Location Information - Enter the provider name. Enter the provider address, without a comma between the city and state, and a nine-digit zip code, without a hyphen. Enter the telephone number of the facility where services were rendered, if other than home or office.
Submission of the CMS 1500 (02/12) claim form should either be typed or computer printed forms. Handwritten forms can cause delays and errors in processing and slow down time for reimbursement. Ensure to use all capital typeface with Courier New or Tines New Roman font style and size 10.
What is it? Box 33 is used to indicate the name and address of the Billing Provider that is requesting to be paid for the services rendered. Enter the name, address, city, state, and ZIP code.
Billing Provider Information Phone Number name, address, and phone number of provider requesting to be paid for services rendered. Billing provider address on both a CMS 1500 and UB must be the physical location; not a PO Box.
This is a required field and must be filled in completely. On the first line enter the street address; the second line, the city and state; the third line, the ZIP code and Page 2 Instructions on how to fill out the CMS 1500 Form telephone number.
Item 27 on the CMS-1500 claim form allows the provider to indicate whether they accept or do not accept assignment. When accepting assignment, the beneficiary may be billed for the 20% coinsurance, any unmet deductible and for services not covered by Medicare.
How to fill out a CMS-1500 form The type of insurance and the insureds ID number. The patients full name. The patients date of birth. The insureds full name, if applicable. The patients address. The patients relationship to the insured, if applicable. The insureds address, if applicable. Field reserved for NUCC use.

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