RelayHealth Clearinghouse New 1500 Claim Form version 02/12

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Gavin Walker
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RelayHealth Clearinghouse New 1500 Claim Form version 02/12

Post by Gavin Walker » Wed Jan 22, 2014 9:59 am

The new 1500 Claim Form (version 02/12) is now available for Professional paper claims. This form has been approved by the National Uniform Claim Committee and the Centers for Medicare & Medicaid Services.

Please use the following CPIDs for Professional paper claims:
  • CPID 4320 Commercial CMS 1500 02/12
    CPID 4321 Medicare CMS 1500 02/12
    CPID 4322 Medicaid CMS 1500 02/12
    CPID 4323 Blue Shield CMS 1500 02/12
    CPID 4335 Patient Direct CMS 1500 02/12
    CPID 4336 Commercial Carr Direct 02/12
For more information, please click here.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

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