Health Care The CMS-1500 (02/12) is the professional claim form submitted by medical professionals. Each area of the form is matched by an electronic field when claims are submitted electronically. Understanding the areas of the form, and each data point is important to make sure the information gets to t

The CMS-1500 (02/12) is the professional claim form submitted by medical professionals. Each area of the form is matched by an electronic field when claims are submitted electronically. Understanding the areas of the form, and each data point is important to make sure the information gets to the insurance correctly and also being able to backtrack the problem in the office if claims are not being paid properly.

Download the Patient Information Sheets and CMS-1500 form provided
Using the information provided about the patient, insurance company and encounter information, complete the CMS-1500 form
Refer to the information provided in Unit 6 Content for assistance
Upload the completed CMS-1500 Forms