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How to prepare Form CMS-3427

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Video instructions and help with filling out and completing Form CMS-3427

Instructions and Help about Form CMS-3427

Welcome to go beyond learning experiences to code Metro our goal in creating this series is to Pryor with tangible oftentimes little-known tips that you can apply to both your business and your career our topics will vary as will our speakers, and we welcome you to visit our website to get the latest edition of go beyond we appreciate your feedback and invite you to send us your thoughts and questions as well as any suggestions you might have for future topics our first edition of go beyond focuses on tips for completing the CMS 1500 form for faster payment our presenter today is our own chief operating officer Dr. kim finger kim has an extensive background in autism having served as a direct service provider in Connecticut many years ago after which she swayed into the world of executive coaching prior to joining code Metro Kim was the chief operating officer at autism spectrum therapies a large California-based autism services company Kim created the insurance billing department at code Metro and is here to share with you her tips on completing the 1500 form hello it's my pleasure to share with you our tips on how to successfully complete a CMS 1500 form a question were frequently asked by our customers is which fields on the 1500 form must be completed for the CMS form to be accepted and not rejected by the insurance carrier, so today we're going to answer this question as well as review which fields are optional to complete and which can be left blank we'll also be reviewing what information is entered in each of the mandatory and optional fields recognizing that the language on the 1500 form is foreign to most providers and a source of confusion when preparing the form okay let's take a look at the 1500 form there are 33 fields on the form of which two fields can always be left blank without worry and that's field 10d reserved for local use and field 15 if patient has had same or similar illness give first date now that we have those out of the way let's talk about the fields that must be completed to submit a clean claim before we go through the numbered fields let's start with entering the name and address of the insurance company in the top right-hand corner of the form although you may be submitting the form electronically the name and address of the insurance carrier must be included in this space on the form itself field 1a is a required field in this field you will enter the patient's insurance policy number as indicated on their insurance card in some cases the card will be in the parents name and their policy number will be entered here the ID number though will reflect not the parent but the patient's insurance ID number fields 2 camp; 5 capture patient name and address and must be completed the only optional.

Common Mistakes

Utilizing the incorrect Social Security Number
Failure to sign your blank
Mailing your form to the wrong address
Overlooking the deadline
Failure to save a duplicate of authorized form

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FAQ - Form CMS-3427

What is the purpose of Form CMS-3427?
This form includes the following information. Form CMS-3427 includes a statement that it is an accurate and complete report of the business transactions or transactions of the taxpayer during the period specified in the form, and has been prepared by an officer, employee, or agent of the IRS based on the information, opinions, or statements furnished by the taxpayer or by any other person, firm, or entity furnishing information on the taxpayer's behalf, in accordance with applicable law or rules. This statement is not a statement that the information is true, correct, or complete, and is not a statement that the information is any particular person, firm, or entity's own information, opinion, or statement. The name of the holder of information on Form CMS-3427 is displayed on this form. (See the Glossary at the end of this chapter for other information.) What information is included on the form? The following is a detailed listing of some of the information that is required on Form CMS-3427.
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