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CMS 1500 Form Update (August 6, 2013) - Transition Timeline Announced

On July 18, 2013 The Center for Medicare and Medicaid  Services (CMS) issued a transition timeline for converting to the new CMS-1500 form (02/12).  On Tuesday, August 6, 2013, the NUCC announced they will follow that same timeline.  The Office of Management and Budget (OMB) approved the claim form under OMB Number 0938-1197.

 

Both CMS and the NUCC have issued their transition timelines, affecting providers that accept government and private insurance.  The final transition timeline for implementation of the revised CMS-1500 claim form is as follows:

• January 6, 2014: Private insurance carriers and Medicare begin receiving and processing paper claims on the revised CMS-1500 claim form (02/12)

• January 6 - March 31, 2014: Dual-use period during which private insurance carriers and Medicare continue to receive and process paper claims submitted on either version of the form

• April 1, 2014: The current claim form (08/05) is discontinued; all private insurance carriers and Medicare receives and processes paper claims submitted only on the revised CMS-1500 claim form (02/12)

 

It’s important to note, too, that the transition will be gradual, and testing will be ongoing through the transition period ending on March 31, 2014. 

 

Remember: Providers will need to check with their payer and/or clearinghouses to determine when they will begin to accept the revised forms. During the transition period, we will continue to inventory and sell our current stock of the previous CMS-1500 form (08/05).

 
CMS 1500 Form Update (June 17, 2013) - The Revised CMS 1500 Form Released -

The NUCC is pleased to announce the approval of the Version 02/12 1500 Health Insurance Claim Form (1500 Claim Form) that accommodates reporting needs for ICD-10 and aligns with requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type 3. The Office of Management and Budget (OMB) has approved the 1500 Claim Form under OMB Number 0938-1197.

 

During its work, the NUCC was made aware by the health care industry of two priorities that were included in the revisions to the 1500 Claim Form. The first was the addition of an indicator in Item Number 21 to identify the version of the diagnosis code set being report, i.e., ICD-9 or ICD-10. The need to identify which version of the code set is being reported will be important during the implementation period of ICD-10. The second priority was to expand the number of diagnosis codes that can be reported in Item Number 21, which was increased from 4 to 12. Additional revisions will improve the accuracy of the data reported, such as being able to identify the role of the provider reported in Item Number 17 and the specific dates reported in Item Number 14.

The NUCC will be reviewing its initial proposed implementation timeline and will seek input from its members, including Medicare. An announcement will be made once the NUCC has finalized its transition timeline. In the meantime, organizations should begin work on the programming and implementation needs for the revised 1500 Claim Form.

Providers will need to check with their payer and/or clearinghouses to determine when they will begin to accept the revised forms.

CMS 1500 Form Update (March 14, 2013) - The Revised CMS-1500 Form...at a Glance -The National Uniform Claim Committee (NUCC) has approved a revised CMS 1500 health insurance claim form (version 02/12) to replace the current form (version 08/05). We worked directly with the NUCC on the form's development and distribution. 
Our CMS 1500 offers some distinct advantages for healthcare customers.  It is 100% compliant and printed to exact specifications.  It also uses soy-based OCR "dropout" red ink and SFI (Sustainable Forestry Initiative) 20# paper for greater scanning accuracy.  As a result we're so confident of our CMS 1500 form's acceptance by insurance carriers that we offer Anti-Rejection Protection™.* Our forms are fully compliant and rejection-proof, to ensure quicker payment by insurance companies.
 
The revisions, which better align the CMS 1500 with certain changes in the electronic Health Care Claims, include:
 

 1500 symbol replaced with a scannable QR code that takes the user to the NUCC CMS-1500 landing page.

 Field 1 - Minor changes to the wording of payer ID number requirements.
 Field 8 - Changed to "RESERVED FOR NUCCC USE" ("PATIENT STATUS" removed from the form).

 Field 9b and 9c - Replaced with "RESERVED FOR NUCC USE" ("EMPLOYER'S NAME OR SCHOOL NAME" removed      from the form).

 Field 10d - Changed to "CLAIM CODES" (Designated by NUCC)."
 Field 11b - Changed to "OTHER CLAIM ID (Designated by NUCC)."
 Field 14 - Minor changes to layout of field.
 Field 15 - Removed "IF PATIENT HAS HAD SAME OR SIMIILAR ILLNESS, GIVE FIRST DATE."
 Field 17 - Added a field to report a qualifier to identify which provider is being reported.
 Field 21 - Added eight additional lines for diagnosis or nature of illness/injury.
 Field 30 - Replaced with "Rsvd for NUCC Use" ("BALANCE DUE" removed from the form).
 
*If a CMS-1500 form manufactured by us is rejected by an insurance carrier due to improper formatting or print quality, we will provide a full replacement order of your purchased forms.  To qualify, you must notify us no later than 20 days after the rejection letter is issued.  Upon review of the rejection letter and confirmation that the rejected forms were manufactured by us, we will send a full replacement order of the affected items.  This Anti-Rejection Protection™ limited warranty applies to rejections based on the form itself being invalid due to ink quality or formatting, such as data elements being improperly positioned or misaligned.  This protection does not apply to missing or incorrect entries provided by the user.
 
For questions or more information regarding these revisions please contact customercare@justcms1500forms.com
 

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