Guidelines for Using the 1500 Claim Form The 1500 billing form is the connection from the practice to a payer, and in this case the Medicare Administrative Contractor (MAC). Whether you are billing on paper or electronically, each field should be completed exactly according to the guidelines to ensure proper claims payment. These two helpful…
Medicare Claims – Paper vs Electronic
What are the Rules? Since October 16, 2003, The Administrative Simplification Compliance Act (ASCA) prohibits payment of initial health care claims not sent electronically, except in limited situations. The exclusion that applies to most doctors of chiropractic is the ‘small provider claims.’ CMS states: The word “provider” is being used generically here to refer to…
EDI Enrollment vs Paper Claims
Electronic Data Interchange vs Paper Billing Once the Medicare enrollment application is approved, providers are assigned a Provider Transaction Access Number (PTAN) along with an Effective Date. This number is exclusive to Original Medicare Part B and will never be used in conjunction with any other Medicare Plan, such as Medicare Advantage Plans or Railroad…