There's some important information we'll need from you to properly process your bill. The CMS 1500 form is used by healthcare providers to bill insurance companies for professional medical services (we bill your insurance using an electronic version of this form). To ensure your claim is processed accurately and promptly, it's critical to complete the form correctly with all required patient and service information. This article will walk you through the CMS 1500 form with each required field and the corresponding details needed to process claims efficiently.
Demographic information
Mandatory fields we require to bill your insurance include:
- Client’s full name: it is important that this matches what your insurance has on file
- Client’s date of birth: this should match what is on file with your insurance
- Client’s sex: This should match the sex that is on file with your insurance provider
- Client’s address: This should match the state in which services are rendered (this is important to make sure providers are licensed to provider services in that state)
Insurance information
Mandatory fields we require to bill your insurance include:
- Member ID Number: Insurance ID for your insurance carrier
- Subscriber name: what is the name of the person that carries the insurance
- Subscriber sex: this should match what is on file with your insurance
- Subscriber address: mailing address of the person that carries the insurance
Additional Resources
- What is an explanation of benefits (EOB)? - explains what is an EOB, typical information found within an EOB, claim processing steps and timelines, and how much you owe based on the EOB.
- Common Insurance Denials - explains the Coordination of Benefits process when using multiple insurance policies, and walks you through common denial scenarios.