Kukonzekera Fomu ya Claim Claim Medical

Fomu ya Malipiro a Ofesi ya Medical Medical Medicare, Medicaid, ndi Insurerrs

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CMS-1500 ndi fomu yofiira-in-white-paper-standard claim fomu yomwe amagwiritsidwa ntchito ndi madokotala ndi ogulitsa katundu chifukwa cha kulipira kubwereza. Ngakhale kuti inayambitsidwa ndi Centers for Medicare ndi Medicaid (CMS), yakhala mawonekedwe omwe amagwiritsidwa ntchito ndi ogulitsa inshuwalansi onse.

Amakonzedwanso nthawi ndi nthawi. Kuyambira pa 1 April, 2014, tsamba lokonzanso la 02/12 ndilolo lovomerezedwa ndi Medicare.

Chikulire chaka 08/05 sichithandizanso.

Kodi Bill angayankhe ndani pogwiritsa ntchito CMS-1500?

Aliyense wosapereka chithandizo ndi wogulitsa angagwiritse ntchito CMS-1500 kuti adziwe zachipatala .

• Ntchito zachipatala
• Othandizira azachipatala
• Namwino openda
• Akatswiri a namwino a chipatala
• Namwino azamwino
• Ovomerezedwa ovomerezedwa amwino olemba anesthetists
• Akatswiri a zamaganizo a zamaganizo
• Achipatala ogwira nawo ntchito
• Home dialysis imapereka ndi zipangizo
• Mapulogalamu ambululu
• Ntchito zachipatala zothandizira odwala

Malangizo Okonzekera CMS-1500

• Onetsetsani kuti deta yonse imalowa molondola komanso molondola m'minda yoyenera.
• Lowani uthenga wa inshuwalansi kuphatikizapo dzina la wodwalayo momwe ziwonekera pa khadi la inshuwalansi.
• Gwiritsani ntchito zizindikiro zolondola za matenda opatsirana (ICD-9) ndi ndondomeko zoyenera (CPT / HCPCS) pogwiritsa ntchito kusintha komwe kumafunika.
• Gwiritsani ntchito adiresi yokhayoyi pa munda wa malo ogwira ntchito.
• Musaiwale kuti muphatikize mfundo za NPI zomwe zasonyezedwa.

Maumboni ochuluka angapezeke pa www.cms.gov kapena www.nucc.org

Kukonzanso kwa CMS 1500 - Version 02/12

Kugwira ntchito pa January 6, 2014, mawonekedwe atsopano (02/12) a mawonekedwe a CMS 1500 anavomerezedwa kuti agwiritsidwe ntchito. Ndondomeko ya CMS 1500 yomwe inakonzedwanso (tsamba 02/12) inakonzedwa kuti ikugwirizana ndi kusintha kwa kayendedwe ka magetsi kuchokera ku malemba 4010 mpaka 5010 a 837P komanso kusintha kwa ICD 9 mpaka ICD 10.

Fomuyi inayambika pa January 6, 2014. Kuyambira pa April 1, 2014, opereka angathe kugwiritsa ntchito mawonekedwe atsopano a CMS 1500 (tsamba 02/12). Masamba otsala a 08/05 sayenera kugwiritsidwa ntchito.

Kusiyana pakati pa Version 08/05 ndi Version 02/12

1. Mutu: Chizindikiro chamakona chinachotsedwa ndi QR code.
2. Malowa Woyamba 1: TRAMPARE CHAMPUS inalowetsedwa ndi TRICARE; SSN inasinthidwa ndi ID #
3. Munda wa 8: PATIENT STATUS inalowetsedwa ndi NTCHITO YOTSATIRA NUCC
4. Mapepala 9b: ZINTHU ZINA ZOMWE ZABWINO ZA KUZABWERA, CHISINDIKIZO CHINASINTHIDWA NDI KUSANKHIDWA KWA NUCC
5. Mapepala 92: DZINA LA WOMWAMBA KAPENA SUKULU inalowetsedwa ndi KUSANKHIDWA KWA NUCC KUGWIRITSIDWA
6. MALO OTHANDIZA MALO 10d: KUSANKHIDWA KWA NTCHITO YOPHUNZITSIRA MALO OYAMBA kunalowetsedwa ndi CODES CLAIM (Yopangidwa ndi NUCC)
7. MALO OTHANDIZA 11b: DZINA LA OMWAMBA KOMA SUKULU inalowetsedwa ndi ID YINA YOLINGALIRA (Yopangidwa ndi NUCC); Mzere wapadontho unaphatikiziridwa kuti ugwiritse ntchito kugwiritsa ntchito chiwerengero cha zilembo ziwiri
8. Malo Opeza Munda 14: DATE LA CURRENT (Mtsuko wofiira) CHIYAMBI (chizindikiro choyamba) KODI INJURY (ngozi) kapena PREGNANCY (LMP) inalowetsedwa ndi DATE OF CURRENT ILLNESS, INJURY, kapena PREGNANCY (LMP); CHOYAMBA chinawonjezeredwa, ndipo mzere wolembapo unawonjezeredwa kuti ugwiritse ntchito kugwiritsa ntchito chiwerengero cha majindi atatu
9. Mapepala a Munda 15: NGATI NGATI PATIENT ANAKHALA NDI MALIMU AMENE AMAKHALA. Perekani NTHAWI YOTSATIRA inalowetsedwa ndi OTHER DATE; CHOYAMBA chinawonjezeredwa, ndipo mzere wolembapo unawonjezeredwa kuti ugwiritse ntchito kugwiritsa ntchito chiwerengero cha majindi atatu

1. Mapepala a Munda 17: Mzere wodutsa unaphatikiziridwa kuti ugwiritse ntchito kugwiritsa ntchito chiwerengero cha chiwerengero cha chiwerengero chachiwiri
2. MALO OTHANDIZA MALO 19: KUSANKHIDWA KWA NTCHITO YOPHUNZITSIDWA MALO OTHANDIZA ZINTHU ZINASINTHIDWA NDI ZINTHU ZOFUNIKA KUDZIWA ZOTHANDIZA (Zosankhidwa ndi NUCC)
3. Malo Opeza Munda 21: ICD Ind. Adawonjezeredwa ndipo mzere wagawo unaphatikizidwira kuti ugwiritse ntchito chiwerengero cha zilembo 1; 8 mizere yowonjezera inawonjezeredwa ndi zizindikiro za matenda; Malemba a mizere ya ma code adasinthidwa kuyambira manambala kupita ku alphas
4. Munda Woyambira 22: MEDICAID RESUBMISSION inalowetsedwa ndi RESUBMISSION
5. Mapepala a Munda 30: BALANCE DUE adasinthidwa ndi Rsvd kwa NUCC Ntchito