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Who can complete a claim form 1500?


Alice Scott:
Hello, Your articles are great and very helpful.  You are now in my favorites!
My question:
•   Can anyone complete a Claim Form 1500?  Or just a biller/provider?
•   Can a patient complete on behalf of a Physician? 
•   Can anyone (other than biller/physician) re-enter info from a bill or receipt onto a 1500 form for "insurance purposes" ?

Hi Mars,
   Glad you are enjoying our website and articles.  We try to add new info every week.

   The CMS 1500 forms are meant for providers to complete on behalf of their patients.  If a patient needs to submit a bill directly, usually they have a claim form provided by their insurance carrier that they attach a statement from their provider’s office (which can be a CMS form, or another form of statement).  It would be difficult for a patient to complete one on behalf of the physician since they would need to data from the physician (tax id#, NPI #, billing info, cpt codes, icd9 dx codes, etc.) and they would have to know where to place the info on the CMS form.

  I don’t think that insurance carriers allow ‘anyone’ to re-enter information since they have to worry about fraud.  Only a dr can diagnose a patient and state what services were performed.  The patient shouldn’t be able to change information given to an insurance carrier by a dr.

I was checking your website
It has a lot valuable information as a library where I can come in and learn more
Just a suggestion to help you out, your website is not responsive, meaning that it can't be seen well. If someone using their cell phone is looking at your website, they won't be able to read the contents unless they zoom in using their fingers. The ability to have a good user experience is very important nowadays.
I also noticed other problems with your website.
Send me a message if you are interested

My own health insurance company actually gives us a CMS-1500 form we can fill out but provider has to sign it. Only difference is the claims address is at the top. It's mainly for those physicians we might see that don't take insurance. I've seen other very small TPA's have their own CMS-500 "LIKE" forms that patients bring in sometimes.

Thanks Martin.  We appreciate the feedback.  Our website is in need of an overhaul, we just haven't had the time yet.  Too many things happening at one time and that unfortunately gets pushed to the bottom of the todo list.


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