National Uniform Claim Committee

National Uniform Claim Committee CMS-1500 Claim - nucc.org

National Uniform Claim Committee . 1500 Health Insurance Claim Form . Reference Instruction Manual . for Form Version 02/12 . July 2018 . Version 6.0 7/18

  Form, Instructions

National Uniform Claim Committee CMS-1500 Claim

The 1500 Health Insurance Claim Form (1500 Claim Form) answers th e needs of many health care payers. It is the basic paper claim form prescribed by many payers for claims submitted by physicians and suppliers, and in some cases, for am bulance services.

  Form, Claim form, Claim

National Uniform Claim Committee CMS-1500 Claim

The NUCC has developed this general instructions document for completing the 1500Claim Form. This document is intended to be a guide for completing the 1500 Claim Form and not definitive instructions for this purpose. Any user of this document should refer to the most current federal, state, or other payer instructions for specific

  Form, Instructions, Committees, National, Claim, Uniform, 1500, Completing, For completing, National uniform claim committee cms, 1500 claim, 1500 claim form

National Uniform Claim Committee CMS-1500 Claim - NUCC

Any payer-specific instructions for completion of the 1500 Claim Form need to be maintained in a separate document. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by the AMA or the NUCC. You should consult with an appropriate

  Completion, 1500

SAMPL E - nucc.org

APPROVED OMB-0938-1197 FORM 1500 (02-12) 1a. INSURED’S I.D. NUMBER (For Program in Item 1) 4. INSURED’S NAME (Last Name, First Name, Middle Initial)

1500 Form Mapping to 837 Claim Transaction - NUCC

1500 Claim Form Map to the X12 837 Health Care Claim: Professional The following is a crosswalk of the 1500 Health Care Claim Form to the X12 837 Health Care Claim: Professional Version 4010A1 electronic transaction. This document is meant to be used in conjunction with the NUCC Data Set.

  Transactions

UB-04 Claim Form Instructions - Geisinger

56. National Provider Identifier Billing Provider (NPI) Unique identifier assigned to the provider. Seven digit RI Medical Assistance Provider ID if not submitting NPI. 57. Other Provider Identifier Taxonomy must be entered if NPI is entered in location 56. This id must be entered in line A,B,C that corresponds to the line in which the “RI

  National, Provider, Identifiers, National provider identifier, Provider identifier, Ub 04