How To: Create CMS-1500 Claims

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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.

createcms.png

(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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Comments

  • Avatar
    Michelle Moreno

    Is there a way to print the CMS form with the signature box in the bottom left corner blank? I've had CMS forms returned because they wanted an original signature from the provider and there isn't a place to do it unless I sign on the bottom margins.

  • Avatar
    Laura

    Michelle,

    Unfortunately there is not a way to blank out this information in TherapyNotes. One workaround is to edit the PDF before printing the CMS-1500 form. Another is to white-out the box after printing it and hand-write over it.

  • Avatar
    Terianne Harrison

    How do I edit the PDF so I can delete information before printing?

  • Avatar
    Sean Behan

    Hi Terianne,

    A member of our support team will reach out to you for assistance.