To print CMS 1500 claim form, you will need a copy of Adobe Acrobat Reader, which you can download for free right here . Download the form below and open the PDF using the Acrobat Reader software, then simply enter your information into the form fields and print onto your pre-printed CMS-1500 claim forms using an inkjet or laser printer.

837 file
Form CMS-1500 is the standard paper claim form used to bill an insurance for rendered services and supplies. It provides information about the client, their corresponding insurance policy, and their diagnosis and treatment. Additionally, most insurances allow you to send an electronic version, called an 837 file.

The ANSI ASC X12N 837I (Institutional) Version 5010A2 is the current electronic claim version. To learn more, visit the ASC X12 website. What’s Changed? The National Uniform Billing Committee (NUBC) makes its UB-04 manual available through its website.

You can enter an insurance payment in two places in SimplePractice:

1. From a client’s Billing page: Go to a client’s Billing page and click the blue Add Insurance Payment.
2. From the insurance billing page: Go to Billing > Insurance > Add Payment.

Enter the patient’s mailing address and telephone number. On the first line enter the street address; the second line, the city and state; the third line, the ZIP code and Page 2 Instructions on how to fill out the CMS 1500 Form telephone number. If Medicare is primary, leave blank.

Medicare only accepts the revised version, 2/12, of the CMS 1500 form. The older version, 08/05, is outdated. Make sure you have the correct version before submission. Who can bill claims? Very Well Health says, “any non-institutional provider and supplier can use the CMS 1500 for billing medical claims.”

To look at it a little more closely (and put it in layman’s terms), Therabill tells us the CMS HCFA 1500 form is the “standard paper claim form used to bill an insurance for rendered services and supplies. It provides information about the client, their corresponding insurance policy, and their diagnosis and treatment.

The only acceptable claim forms are those printed in Flint OCR Red, J6983, (or exact match) ink. The “static” form fileds are visible on the screen only. They are for easy orientation while you are entering your medical claim.