If you’ve gone through the process of becoming an in-network provider with a number of insurance companies, I am sure you can’t wait to put this new credentialing to use and start filing claims for your clients. The first step in filing a claim starts with filing out a CMS 1500.
What is a CMS 1500?
The CMS 1500 is an insurance claim form for non-institutionalized healthcare providers (such as private practice dietitians!) If you come from a clinical background, a CMS 1500 is like a UB-04. You fill out this form each time you wish to submit a claim.
The CMS 1500 requires:
– Client personal information, such as name, date of birth, gender, address, along with their relationship to the Insured
– Referral information (if required by insurance company)
– Your provider information (this includes your NPI, In-Network provider ID, and additional information as required by individual company)
– Your practice’s information (such as Location NPI and address)
– Billing Information
– Insurance Policy Information
– Diagnosis (This is where CPT and ICD-10 codes will come in handy!)
Pro Tip: Healthie makes filling out CMS 1500’s a breeze with our in-platform CMS 1500 form creator. Ask for the information you need from your client right during the intake form process and Healthie’s CMS 1500 creator will auto-fill each new form after the first time you’ve created it! Healthie’s CMS 1500s are compatible with clearinghouses such as Office Ally to make filing a claim easier than ever.
Clearinghouses and CMS 1500s
Once you have filled out your CMS 1500, you must submit it to a clearinghouse. A clearinghouse is a third party company who handles your CMS 1500s and coordinates with the insurance company to pay for your services. Clearinghouses are often digitized nowadays, and tend to act as a central way to keep track of your claims and update you on their status. With Healthie, you can note the status of a claim in our system to keep you in the loop!
Looking for more on private practice insurance? Let us know at firstname.lastname@example.org!