Transcription of National Uniform Claim Committee CMS-1500 Claim
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National Uniform Claim Committee 1500 Health Insurance Claim Form Reference instruction manual for Form Version 02/12. July 2018. Version 7/18. Version 7/18. Disclaimer and Notices 2018 American Medical Association This document is published in cooperation with the National Uniform Claim Committee (NUCC) by the American Medical Association (AMA). Permission is granted to any individual to copy and distribute this material as long as the copyright statement is included, the contents are not changed, and the copies are not sold or licensed. Applicable FARS/DFARS restrictions apply. The 1500 Health Insurance Claim Form (1500 Claim Form) is in the public domain. The NUCC has developed this general instructions document for completing the 1500 Claim Form. This document is intended to be a guide for completing the 1500 Claim Form and not definitive instructions for this purpose.
National Uniform Claim Committee . 1500 Health Insurance Claim Form . Reference Instruction Manual . for Form Version 02/12 . July 2018 . Version 6.0 7/18
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