[PDF] Instructions for Making a Claim Instructions pour présenter une - Téléphones

How do I write a claim form?

INSTRUCTIONS: Enter in the white, open carrier area the name and address of the payer to whom this claim is being sent. Enter the name and address information in the following format: Do not use punctuation (i.e., commas, periods) or other symbols in the address (e.g., 123 N Main Street 101 instead of 123 N. Main Street, #101).

How do I enter a claim code?

DESCRIPTION: The “Claim Codes” identify additional information about the patient’s condition or the claim. FIELD SPECIFICATION: This field allows for the entry of 19 characters. INSTRUCTIONS: Enter the insured’s policy or group number as it appears on the insured’s health care identification card.

What should I do after reading the 1500 claim form?

After reading the 1500 Claim Form and Instructions Criteria, complete all sections of the form and be as thorough as possible explaining the request. Include specific information and documentation that supports the need for the change and how the criteria are met.

When did the 1500 claim form instructions come out?

The 1500 Claim Form instructions were initially approved by the NUCC in November 2005. The NUCC continues to research the type of data that are typically reported, as well as the required data elements that may apply to public and private payers. Therefore, the instructions have and will continue to evolve.