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.
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
- Under Paper Claims, configure how you want CMS-1500 forms to be printed
- 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
(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.
- 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.
- Review the CMS-1500 carefully before printing and mailing to the payer. Mail the completed CMS-1500 form to the payer's paper claims address
- Once you receive reimbursement from the payer, enter the insurance payment in the TherapyNotes. To learn more, read How To: Enter Insurance Payments
- If you are enrolled to receive electronic remittance advice (ERA) from the payer, post the ERA payment to TherapyNotes. To learn more, read How To: Post ERA Payments