How To: Create CMS-1500 Claims

A CMS-1500 form, previously known as a HCFA form, is a paper claim that you can generate through TherapyNotes and print and mail to the payer for reimbursement. TherapyNotes allows you to easily create and print CMS-1500 claims to send to payers using your choice of pre-printed red CMS-1500 forms or printing the red form background with your claim.

For payers who do not require paper CMS-1500 claims, we highly recommend submitting claims electronically using TherapyNotes EDI (electronic data interchange). For more information, read How To: Submit Electronic (EDI) Claims.

Role Required: Practice Biller

CMS-1500 Printing Options

When generating a CMS-1500 claim, TherapyNotes allows you to choose to print your data onto pre-printed red forms or print the red form background along with your data. CMS-1500 forms can be purchased from a variety of places and may be required by some payers. Adjust your printing settings to make sure the data you print lines up correctly with the pre-printed form.

To configure CMS-1500 printing options for your practice:

Note: Both Practice Billers and Practice Administrators can configure Practice Billing settings.

  • Click the User Icon > Settings > Practice Billing

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  • Under Paper Claims, configure how you want CMS-1500 forms to be printed
Quick Tip: For best results when printing on pre-printed CMS-1500 red forms, print in high quality and use a paper tray rather than a document feeder - a paper tray tends to feed paper to the printer more evenly. If the content of the CMS-1500 isn't aligned with the pre-printed form, adjust the margin offsets and click Generate Test Form Using These Settings to print a test form.
  • Click the Save Billing Settings button

Creating CMS-1500 Forms

CMS-1500 claims can be generated once a clinician completes and signs a billable note for a client who is set up to bill their insurance. The bubble next to Create CMS-1500 throughout TherapyNotes (such as on the main Billing page and on your To-Do list) will display the number of CMS-1500 claims that are ready to be submitted.

Before creating a CMS-1500:

  • Click Patients > Patient Name > Patient Billing tab
  • Under Search Billing Transactions, click the date(s) of service you want to create a CMS-1500 for
  • Verify that the Method for the corresponding date(s) of service is set to Insurance - In Network - Paper or Insurance - Out of Network - Paper. For additional guidance, read How To: Set Billing Method

To generate a CMS-1500 form:

  • Do one of the following
    • Click To-Do > Create CMS-1500 forms
    • Click Billing > Create CMS-1500
    • Click Payers > Payer Name > Payer Billing tab > Create CMS-1500
  • Under Search Billing Transactions, click the bold Pending Paper or Resubmit Paper link next to the date of service you want to bill for
Quick Tip: To submit CMS-1500 forms for a specific client, click Patients > Patient Name > Patient Billing tab > Create CMS-1500. This automatically lists all dates of service for the client that are eligible for paper claim submission on the Create CMS-1500 Form page.

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(A) Include on CMS: Select the checkbox next to the dates of service you want to include on the CMS-1500. TherapyNotes batches up to six dates of service per client on a single CMS-1500.

(B) Document Format: From this dropdown, select whether you are using pre-printed CMS-1500 forms or you are printing the red background with the rest of the content of the CMS-1500.

Quick Tip: While some payers will accept a CMS-1500 form with a black-and-white background, other payers may reject claims that do not include the standard background in red ink. For this reason, we do not recommend printing CMS-1500 forms in grayscale. To reduce the likelihood of claim rejections, use pre-printed CMS-1500 forms or use a color printer with red ink to print your CMS-1500.
  • Click the Download CMS-1500 button. The CMS-1500 will download as a PDF
  • TherapyNotes will prepare your document in a blue bar at the bottom of your browser. When your CMS-1500 is ready, click the Ready: Click to Download link

To create a CMS-1500 claim for a secondary payer, read Secondary Insurance.

Next Steps

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