10 Tips for Handling Forms in Medical Billing and Coding

3 Jun

New specialist in the field are prone to making a few mistakes along the way and even some medical billing and coding specialist that have worked in the field for several years are still not immune to making mistakes. Unfortunately, these mistakes have been known to cost families and individuals hundreds or even thousands of dollars. It is also unfortunate that when these mistakes are made they cannot be easily undone. Below are ten tips that can be utilized by specialist to keep these errors at bay. The form that a majority of the mistakes are made on is the CMS 1500, which can result in form rejections. Below are 10 tips on how to handle CMS 1500 forms.

When it comes to filling in CMS 1500 forms it is important to understand that the information filled out on the CMS 1500 forms need to be exact and accurate. If you are new to the field then filling out the forms for the first time may seem difficult.

CMS Formatting Tips

1. When filling out the form online the best 10-12 size font in Arial. Avoid using hyphens, periods and even dollar signs.

2. If filling out the paper version of the form then it is best to use blue or black in and the same goes for online filings the font needs to be in blue or black.

3. Red colored font is not allowed on the online for and neither is red ink on the paper version (this is in part due to the form itself typically coming in red).

4. The data that you enter into on the paper form and the online form should be placed centered in the box so that the words will not touch the edges of the box. Make sure that you use the standard codes provided to fill out the form in its entirety and try to stay away from telling a story, make sure the text is to the point.

5. When you receive your CMS 1500 form it will arrive with perforations, be sure to tear these off so that when you submit your CMS 1500 form it is 8 in a half by 11. If you are placing any attachments to the form such as a copy of the patients’ insurance card or other information it MUST be smaller than the actual CMS form itself.

6. While you need to make a copy of the CMS 1500 form for your own records, you must NEVER send in the copy. If the original is not sent in it will be automatically rejected.

The following will cover other aspects of the CMS 1500 form that needs to be followed so that the facility you are working for will be paid in a timely fashion.

7. The fields that need to be filled out pertaining to the patient and the information provided to you from the doctor are filled in the proper areas on the form. In other words, do not place the DOB (date of birth) in the SSN box.

8. The names should be placed in their proper places. It can sometimes happen that the name of the person on the insurance information is not the patient. This is true when it comes to patients that are under the age of 18 and they are on their legal guardians insurance.

9. A portion that is often missed on the CMS 1500 form is part 11 which asks if the patient is covered by Medicaid or Medicare.

10. To further ensure that the form and the information on it is accurate as it pertains to the patient, have the patient verify the information entered into the form and sign and date the form.


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