RelayHealth Clearinghouse New 1500 Claim Form version 02/12
Posted: 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:
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