Most offices submit electronic claims, but there are still small offices that submit paper claims and other times when a paper claim is simply the easiest way to go. You will know if you have the correct edition of the 1500 form if at the top of the form, it states, “Approved by National Uniform Claim Committee (NUCC) 02/12, and in the bottom right corner, “Approved OMB-0938-1197 Form 1500 (02-12).
The claim form itself is split into three sections: Fields 1-13 are for patient information; fields 14-24 are for procedural and diagnostic information related to services provided; and fields 25-33 are for servicing and billing provider information. To reinforce the concept of the three separate sections, we will be learning the information required to correctly complete the claim form based on the section requirements with questions related to what you just learned, immediately following each section, ending with two scenarios in which you will create a clean 1500 claim based on the information given. In the office situation, all information required to complete the CMS form is found in the patient’s registration form (section 1), superbill and (to verify information) in the medical chart (section 2). The provider and billing provider information will be found in your billing (or front) office (section 3).
http://www.medicalbillingcourseonline.com/1500course.htm
The claim form itself is split into three sections: Fields 1-13 are for patient information; fields 14-24 are for procedural and diagnostic information related to services provided; and fields 25-33 are for servicing and billing provider information. To reinforce the concept of the three separate sections, we will be learning the information required to correctly complete the claim form based on the section requirements with questions related to what you just learned, immediately following each section, ending with two scenarios in which you will create a clean 1500 claim based on the information given. In the office situation, all information required to complete the CMS form is found in the patient’s registration form (section 1), superbill and (to verify information) in the medical chart (section 2). The provider and billing provider information will be found in your billing (or front) office (section 3).
http://www.medicalbillingcourseonline.com/1500course.htm