Insight - Fall 2020

Fall 2020 | 5 1500 Forms The Centers for Medicare & Medicaid Services (CMS) Form 1500 must be used to bill for medical services. Step 1: Blank 1500 Forms a. To begin, you need blank forms. These forms can be obtained from the PBM to which you are sending the claim or here . b. Download the file and extract the contents. There will be three files in the folder. Print the one entitled 508_CMS (front_back) (02-12).pdf. Step 2: 1500 Formats a. Go to Store Control > Pricing Options > 1500 Formats . b. To create a new format, click New . Name your form and click Save . Note : The only fields that can be checked/printed are in the 1500 format list. Step 3: Print the Form After you make the 1500 format, the system will autogenerate a Format ID. Note that ID. a. Go to Reports > Third Party > Third Party Billing Forms . b. For the State Code, type 15A to access the 1500 Forms. c. Enter the Select Option criteria to match the Rx Number and the date for which you want to make the form. d. Complete the Print Options. Click Finish . Values to note: x Option Set?: Type the two- character ID that identifies the 1500 Form Billing Option created in Store Control. x ZIP+4 If Need: This option must be answered as YES. Step 4: Edit Phase Errors a. If there are transactions with errors, the Edit Phase Errors box displays to alert you to fix them before proceeding. If there are no errors, a pop-up box displays for this as well. Click Yes to proceed. b. Verify vertical and horizontal alignment. Enter values and click Next . c. The question “Does the form need to be aligned?” displays. Click No . d. Make sure your printer is loaded with blank 1500 Forms. Click Print . Service Pack Details Fixes happen in between service packs. To review these and stay up-to-date, go to qs1support. com > Software Service Pack Details & Downloads . Select your product, and the service pack and corresponding addendum display. Print CMS Forms Want to automatically print the CMS Notice of Appeals Rights Form? 1. Go to Store Control > Store Level Options > Fastclaim . 2. Check Print CMS Notice for Part D Plans . 3. Verify that the correct Reject Code is present on the claim. You must have a 569 and A5 Reject Code present for it to trigger the system to print the CMS form. Note: Make sure you have a generic text printer driver attached to the printer to which the form is set to print. 4. Go to File > Default Printer Selection > Default Printers > CMS Notice of Appeal of Rights . Make sure you have the correct printer selected for printing the forms. 1500 1500