Claims are generally automatically submitted by doctors and hospitals within your network. However, if you’re seeing an out of network provider, depending on their office policy, they may not be able or willing to submit on your behalf. Therefore, you would have to submit the claim directly with your insurance company for reimbursement. Every insurance company can have their own form, but you can also use a universal claim form, the CMS 1500 (02/12 is the most updated version). You can access the form here:
https://www.cdc.gov/wtc/pdfs/policies/cms-1500-P.pdf
The address to w
here you can submit the claim will be on the back of your insurance card.
For Medicare patients looking to submit for outpatient services, you would use this form:
https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms1490s-english.pdf
I would highly recommend attaching a copy of your receipt so you can show that payment was made. However, you will need specific information from your provider so you can submit this claim form – the provider’s name, address, NPI (National Provider Identification) Number, TIN (Tax Identification Number), ICD-10 (diagnostic) codes, and all procedural codes (also known as CPT codes).
Filed under: pain management
Like this post? Subscribe to my RSS feed and get loads more!
Leave a Reply