Easily Insert Page to the Claims Reporting Form

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How to Insert Page to the Claims Reporting Form

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good day this little presentation is to show you the steps to follow when you want to include an annexure as part of your document of a research proposal or your research project and then it is included at the end of the document so first you go to insert which is over here on your tabs in microsoft word if you click on insert remember you can also insert a page break to have your anexus on different pages and then you click on object then you will get this little block and it will give you an option to choose object or text from file object means you including pdf documents text from file means youre including word documents or excel documents so for this example were going to include a example of editor certificate for example so you click on object then you will get this block that will show you create from file you click on that and then you will get one that says browse go to browse that will take you to your file divider where you will go look for your um an extra that you save

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What goes in box 33 on a CMS 1500?

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 23 in CMS 1500 claim form?

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

What is entered in Block 1 on the CMS 1500 claim form?

BLOCK 1A INSUREDS ID NO. ( The recipient identification number is the nine-digit number found on the South Dakota Medicaid Identification Card. The three-digit generation number that follows the nine-digit recipient number is not part of the recipients ID number and should not be entered on the claim.

What goes in box 19 on a CMS 1500?

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.

How do I fill out a CMS claim form?

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.

How do you fill out a diagnosis pointer on CMS 1500?

Enter the diagnosis reference number (pointer) in the unshaded area. The diagnosis pointer references the line number from field 21 that relates to the reason the service(s) was performed (ex. 1, 2, 3, or 4, or multiple numbers if the service relates to multiple diagnosis from field 21).

What information is needed on the CMS 1500 claim form?

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.

What goes in box 17a on CMS 1500?

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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