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The HCFA 1500 claim form, also known as CMS-1500, enables medical physicians to submit health insurance claims for reimbursement from various government insurance plans including Medicare, Medicaid and Tricare.
CMS was previously known as the Health Care Financing Administration (HCFA) until 2001.
It is also known as the HCFA 1500 form, as it was previously developed and maintained by the Health Care Financing Administration (HCFA). The CMS 1500 form includes information about the patient, the healthcare provider, and the services provided, as well as charges for those services.
A June 14, 2001 press release announced that the name of the Health Care Financing Administration (HCFA) was changed to the Centers for Medicare Medicaid Services (CMS).
ALWAYS choose the TRICARE option. Enter the patients name, using the format Last Name, First Name, Middle Initial and the patients full physical address including post code. Enter the patients DOB using the format MM DD YY and tick M or F to indicate the patients gender.

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If yes, then you can file your claims online. Step 1: Fill out the TRICARE claim form. Download the Patients Request for Medical Payment (DD Form 2642). Step 2: Include a copy of the providers bill. Step 3: Submit the claim. Step 4: Check the status of your claims.
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.
However, the term HCFA is still commonly used to refer to the standard claim form used by healthcare providers to bill Medicare and some private insurance companies. The form is officially known as the HCFA-1500, but it is also sometimes called the CMS-1500 or simply the medical claim form.

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