Skip to main content

Exporting and Submitting US Professional (CMS1500) Claims Manually

Updated over a month ago

Carepatron allows you to export and submit US Professional (CMS1500) claims manually in two ways, depending on the requirements of the insurance payer:

  1. Exporting as a CMS1500 PDF.

  2. Printing directly onto a CMS1500 form.

Exporting a CMS 1500 PDF

To export and submit a CMS 1500 PDF manually, follow these steps:

  1. Open the draft claim.

  2. Validate the claim in the claim header by checking for any errors.

    • Fix any errors that appear.

  3. Once validated, click the Download button and select Export CMS1500.

  4. The claim will be exported as a CMS 1500 PDF, which can be sent to the insurance payer.

  5. Once submitted, click Submit to change the claim status to "Submitted" while the insurance claim is processed.

Printing Directly onto a CMS 1500 Form

To print the claim directly onto a pre-printed CMS 1500 form, follow these steps:

  1. Open the draft claim.

  2. Validate the claim in the claim header by checking for any errors.

    • Fix any errors that appear.

  3. Once validated, click the Download button and select Export text only.

    • This exports the claim as a PDF without borders.

  4. Open the exported PDF and select Print.

  5. Ensure you have loaded the CMS 1500 paper into the printer.

  6. Select the appropriate configuration for your printer.

  7. Once submitted, click Submit to change the claim status to "Submitted" while the insurance claim is processed.

Notes

  • Printing directly onto CMS 1500 forms may require some trial and error.

  • You may need to adjust print margins to align the document correctly with the pre-printed form.

Handling Approved Claims (Manual Submission)

  • When a claim approval comes back, the claim status can be marked as Approved while waiting for payments.

  • If payments are received at the same time, a payment can be added to the claim.

Handling Claim Rejections (Manual Submission)

  • If a claim is rejected, it can be reverted to Draft, edited, and resubmitted.

  • Before exporting, ensure that resubmission codes are set in the Miscellaneous Information section.

Handling Claim Denials (Manual Submission)

  • If a claim is denied, update the claim status to Denied to reflect this in Carepatron.

  • Appeals can be managed manually, and the claim status updated if appeals are successful.

Go to Carepatron

Our team will be able to answer any other questions you may have. Just reply via messenger through the Help channel in your workspace.

Did this answer your question?