Hcfa 487 2025

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The document is an addendum form from the Department of Health and Human Services, specifically for the Health Care Financing Administration. It includes sections for patient information, treatment plans, certification periods, and signatures from healthcare providers. The form is used to document and update medical treatment details.

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Click ‘Get Form’ to open the hcfa 487 in the editor.
Begin by entering the Patient’s HI Claim Number in the designated field at the top of the form. This is crucial for identifying the patient's claim.
Next, fill in the SOC Date and Certification Period. Specify both 'From' and 'To' dates to outline the treatment duration.
In section six, input the Patient’s Name clearly. Ensure that it matches official records for accuracy.
Proceed to enter the Provider Name in section seven, followed by Item No. in section eight, which may refer to specific services or items provided.
The physician must sign and date in sections nine and ten respectively. This validates the treatment plan.
If applicable, include an optional name/signature of a Nurse/Therapist along with their date in sections eleven and twelve.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the new name for HCFA?

HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001.

What is the difference between HCFA 1500 and CMS 1500?

13. INSUREDS OR AUTHORIZED PERSONS SIGNATURE I authorize. payment of medical benefits to the undersigned physician or supplier for. services described below.

What does HCFA stand for?

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).

What is a HCFA in medical billing?

What is HCFA-1500 Form? If you wonder what HCFA stands for, its the Health Care Financing Administration, a federal agency responsible for administering the Medicare and Medicaid programs in the United States.

form 487

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