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Replace Name Field from the Accident Medical Claim Form

Replace Name Field from the Accident Medical Claim Form

Aug 6th, 2022

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How to Replace Name Field from the Accident Medical Claim Form

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46 votes

Joe Moore provides instructions on completing a CMS claim form. Key points include: all entries must be in capital letters and abbreviations are not allowed. In Block 1, select one type of insurance by marking an X in the appropriate box, such as Medicare, Medicaid, or TRICARE. For Block 1a, enter the patient's ID number without any dashes or spaces, regardless of how it's presented on the insurance card. If a group health number exists, it should be positioned further along on the same line, to the far right. The tutorial continues with guidance on filling out Block 2, starting with the patient’s details.

Got questions?

Below are some common questions from our customers that may provide you with the answer you're looking for. If you can't find an answer to your question, please don't hesitate to reach out to us.

What goes in box 21A on CMS 1500?

21A is entered in the Diagnosis Pointer field (Box 24E) to reference the applicable diagnosis code in Box 21A. If the claim for aid-in-dying drugs is submitted by the attending physician, an invoice documenting the cost of the drugs must be submitted as an attachment.

What is the field 9 in CMS 1500 claim form?

9. Name of the INSURED PERSON of other payer in Insurance Information screen under Patient Master.

What is field 24 in CMS 1500 claim form?

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.

What goes in Block 17 on a CMS 1500 form?

Item 17 - Enter the name of the referring or ordering physician if the service or item was ordered or referred by a physician. All physicians who order services or refer Medicare beneficiaries must report this data.

Is Box 17 required on a CMS 1500?

Text Captions: Item 17 Required if services are ordered, referred or supervised. Enter the name and qualifier of the referring, ordering or supervising physician if the item or service was ordered, supervised or referred by a physician.

What is field 23 in CMS 1500 claim form?

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

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.

What goes in box 17b on CMS 1500?

What is it? Box 17b is where the NPI of the referring provider is entered. The NPI number refers to the HIPAA National Provider Identifier number.

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