How Do You Complete an HCFA 1500 Form?


Quick Answer

Completing a CMS HCFA-1500 form requires filling out 33 blocks of information in sequence. The form and a detailed instruction guide can be downloaded at no cost from the official website for the Centers for Medicare & Medicaid Services as well as several other private and publicly run sites.

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Full Answer

The form is a single page with additional information printed on the back. The blank form can be printed to be filled out by hand or filled out online and then printed. The 35-page printable manual provides an easy to follow step-by-step guide for filling out the form. The San Francisco Department of Public Health also provides an abridged version of instructions in addition to a PDF of the instruction book. The blocks that are required are clearly marked.

The CMS HCFA-1500 form is the official standard form used by physicians, private insurers, managed care plans and other providers for submitting bills or claims for reimbursement for health services to Medicare carriers, Medicare administrative contractors and Medicaid State Agencies, reports MDCodeWizard. The CMS website offers a toll-free phone number and online options for additional assistance.

Business websites such as American HCFA Forms offer bulk orders of pre-printed forms with specially designed envelopes for a fee, but the special envelopes are not required for submitting the form.

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