Tuesday, March 11, 2014

Common Errors on CMS-1500 (Version 02/12) Claim Form: Implementation Date 04/01/2014

Helpful Hints to Improve Claim Processing
  • Use a Legible Font – Use a size 10 or 12 font in Courier New style, making sure information is properly aligned on the form.
  • Remove all Staples – Remove all staples, paper clips, or binder clips from claims and attachments. These items may prevent the scanner from properly imaging the claim and corresponding attachments as well as slow down their processing.
  • Remove all Sticky Notes and Stickers – Sticky notes and stickers are often used to convey additional information but often cover information needed for the processing of the claim resulting in additional processing time. Avoid using sticky notes and stickers. Any additional information about the claim should be included on an attachment.
  • Don’t Highlight Information – Although highlighting information is intended to make elements on a claim stand out, it has the reverse affect. When scanned, this information cannot be processed as it appears to be blacked out. Do not use highlighters on paper claims.
  • Refrain from Extraneous Information – Extraneous information on the claim adds additional time to the processing of a claim. Extraneous information can include but is not limited to: descriptions after a diagnosis code, descriptions after a procedure code, any stamped information such as “Corrected Claim” in Item 24, addresses in the margins around the claim form, circling information or using an arrow to indicate important information. 
  • Use the Correct Mailing Address – Using the address that is appropriate for the claim will assist in timely processing. Mailing the claim to the incorrect address can cause delays in processing or possible denials. If Part B, DME, and/or Part A claims need to be submitted, do not submit them in the same envelope. Include only one type of claim per envelope.
View the “CMS-1500 Form Version 02/12 Completion Tips” webpage at med.noridianmedicare.com/web/jeb/topics/claim-submission/cms-1500-claim-form-completion-tips for Item visuals and completion details about the following.
  • Item 17 – Name of Referring Provider or Other Source
  • Item 21 – Diagnosis or Nature of Illness or Injury
  • Item 24E – Diagnosis Pointer
Courtesy of Noridian

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