Insert Advanced Field from the Accident Medical Claim Form and eSign it in minutes

Aug 6th, 2022
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How to Insert Advanced Field from the Accident Medical Claim Form

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[Music] welcome to availability training for outpatient claims cms 1500 when you log into availity click on claims and payments and then professional claim choose your organization which would either be your billing agency or your client choose professional claim then select the company that you want to bill to im going to select aetna we see aetna populated at the top but youll also find other frequently used insurance companies in the drop down area if you make a mistake you can just go here and change the payer rather than going back to the claim portal screen here you have the organization name professional claim transaction type and the responsibility sequence set as primary this indicates that it is a primary payer and not a secondary whether the member has just one insurance policy or they have a second or a third youre specifying that youre billing the primary insurance company first after the claim from the primary insurance company is paid you can then resubmit the claim

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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.
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.
12. PATIENTS OR AUTHORIZED PERSONS SIGNATURE I authorize the release of any medical or other information necessary to process this claim. I also request payment of government benefits either to myself or to the party who accepts assignment below.
9. Name of the INSURED PERSON of other payer in Insurance Information screen under Patient Master.
Box 23 is used to show the payer assigned number authorizing the service(s).
KEY: R = Required | NR = Not Required | S = Situational, only use if appropriate specific to claim Field IDField DescriptionData Type10cS10dCLAIM CODES (DESIGNATED BY NUCC)S11INSUREDS POLICY GROUP OR FECA NUMBERNR11aINSUREDS DATE OF BIRTH, GENDERNR59 more rows
item 11. Enter the employers name, if applicable. If there is a change in the insureds insurance status, e.g., retired, enter either a 6-digit (MM | DD | YY) or 8-digit (MM | DD | CCYY) retirement date preceded by the word RETIRED.
Box 17a. The Other ID number of the referring, ordering, or supervising provider is reported in 17a in the shaded area. The qualifier indicating what the number represents is reported in the qualifier field to the immediate right of 17a.

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