Medical practices submit medical claim forms to insurance providers to receive payment for care rendered to insured patients. Practices submit most claims electronically, but also use paper forms as well. Regulations mandate that practices use CMS 1500 forms as the paper documents for submission to government insurers. The forms are also the standard document for private insurance submissions. Read More
Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
This form was revised to align the paper form with some of the changes in the electronic healthcare claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
The most significant change was the addition of 8 diagnosis codes in field 21
Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
This form was revised to align the paper form with some of the changes in the electronic health care claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
The most significant change was the addition of 8 diagnosis codes in field 21
Includes employment history, references, education, personal information, physical record, check-offs for special questions and space for interviewer's remarks
Privacy Sign-In Sheets That Provide The Level of Privacy That Patients Expect.
Sheets Provided for Patient Name, Arrival Time, Appointment Time, Doctor Or Dept, Indicate Yes Or not for Any Changes To InFormation & Numbering System If Office Chooses To Use
Patient Signs On Removable Strips That Have Adhesive Backs for Attaching to Patient Charts to Improve Record Keeping
Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
This form was revised to align the paper form with some of the changes in the electronic health care claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
The most significant change was the addition of 8 diagnosis codes in field 21
Eliminates the need for multiple warning slips, saving time and paper
Encourages employee accountability by showing employees you are serious, but are willing to give them an opportunity to correct problems
Provides a space for employees to sign the Warning Notice, indicating that they understand the warning and the consequences if their performance does not improve
Use the Voluntary Affirmative Action forms bundle to record efforts to provide equal opportunities for protected veterans and qualified people with disabilities
Comes with a tip sheet covering compliance guidelines and recommended best practices from expert HR and legal teams
