Free cms 1500 form template on word document-2025

1. Click ‘Get Form’ to open the Free CMS 1500 form template in our editor.
2. Begin by filling out the patient’s information in Section 1. This includes the patient's name, address, and date of birth. Ensure that all details match the insurance card to avoid claim rejections.
3. In Section 2, provide the insured's information. If the patient is also the insured, you can check the appropriate box.
4. Proceed to Section 3 where you will enter the provider's details. This includes their National Provider Identifier (NPI) and tax identification number.
5. Complete Sections 4 through 6 by detailing the services provided, including dates of service and procedure codes. Use our platform’s features to easily add or modify entries as needed.
6. Finally, review all sections for accuracy before saving or printing your completed form. Utilize our editor’s tools for a final check.

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