Easily Insert Amount Field to the Claims Reporting Form

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How to Insert Amount Field to the Claims Reporting Form

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good afternoon my name is Anthony way and Im here with my colleague Judy Gonzalez and we are of the Los Angeles County Department of Consumer and business Affairs welcome to Welcome to our webinar please take note that your microphone is currently on mute you may ask questions at any time including during the presentation by submitting through the chat box located on the lower right hand corner of the WebEx page it is a good idea to leave the chat box open even if you dont ask questions because youll be able to view valuable information entered in a chat throughout the webinar this webinar is being recorded and will be available on our website along with other resources just go to dcba.lacounty.gov and click on a small claims tab at the conclusion of todays presentation we would appreciate you completing a four question survey to let us know how we did please give us suggestions for additional webinars all feedback is welcome Judy take it away good afternoon everybody my name is Ju

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What goes in box 32 on the CMS 1500 claim form?

Item 32 - For services payable under the physician fee schedule and anesthesia services, enter the name and address, and ZIP code of the facility if the services were furnished in a hospital, clinic, laboratory, or facility other than the patients home or physicians office.

What is field 26 in CMS 1500 claim form?

ID Qualifier - Enter X if billing for emergency services. 26 optional Patients Account Number -Enter the patients medical record number or account number in this field.

What is field 33 in CMS 1500 claim form?

What does the billing box 33 mean on the CMS 1500 form? Box 33 of the CMS 1500 form derives from the selected employeess Claims Settings area in the contact. Provide the billing providers name, address, NPI, EIN, and the phone number.

What is field 19 on CMS 1500?

What is it? Box 19 is used to identify additional information about the patients condition or the claim. See the NUCC 1500 Health Insurance Claim Form Reference Instruction Manual for additional details.

What is field 19 in CMS 1500 claim form?

Box 19 is commonly used on paper claims for data not otherwise accommodated by the CMS-1500 claim form. Data entered in this field will print but will NOT export electronically. Please contact your payer to determine where the data is expected.

What is the character limit for box 19 on CMS 1500?

The Comments field (i.e., Item 19 on the CMS 1500 claim form) allows up to 80 characters.

What is field 17 on a claim form?

Box 17 - Name of Referring Provider or Other Source Enter the applicable qualifier to identify which provider is being reported. Enter the qualifier to the left of the vertical, dotted line. DN. Referring Provider.

What goes in box 19 on a ub04?

Box 19 If Applicable Reserved for Local Use - Use this area for procedures that require additional information, justification or an Emergency Certification Statement. This section may be used for an unlisted procedure code when explanation is required and clinical review is required.

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Insert Amount Field to the Claims Reporting Form