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

Aug 6th, 2022
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How to Remove 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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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
Box 32 is used to indicate the name and address of the facility where services were rendered. Enter the name, address, city, state, and ZIP code of the location.
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 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.
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.
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.
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.
33b Required Billing Provider Info Phone # (Pay-To) - Used for atypical providers only. Enter the Medi-Cal provider number for the billing provider.
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.
Box 23 is used to show the payer assigned number authorizing the service(s).

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