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

Aug 6th, 2022
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How to Insert Advanced Field in 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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33b Required Billing Provider Info Phone # (Pay-To) - Used for atypical providers only. Enter the Medi-Cal provider number for the billing provider.
Box 13 is the authorization of payment of medical benefits to the provider of service. If this box is completed, the patient is indicating that they want any payments for the services being billed to be sent directly to the provider.
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.
Box 23 is used to show the payer assigned number authorizing the service(s).
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.
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
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.
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.
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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