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As previously communicated, the National Uniform Claim Committee (NUCC) has approved an updated version of its 1500 Health Insurance Claim Form (CMS-1500 claim form). The new claim form (02/12), which went into effect January 6, 2014, accommodates reporting needs for ICD-10 and aligns with data captured on electronic 837 transactions.
As of April 1, 2014, AmeriHealth only receives and processes paper claims submitted on the new CMS-1500 (02/12) claim form. Any paper claims submitted using the old version of the form (08/05) will be rejected.
Note: CMS-1500 (02/12) claim forms can be purchased through office supply stores, local printing companies, orby calling the U.S. Government Printing Office at 1-866-512-1800.
Resources available
For more information about the key changes that were made to the CMS-1500 claim form, please refer to the
detailed article in the March 2014 edition of
Partners in Health UpdateSM. For claims submission addresses by product, please refer to our
payer ID grids.
To assist you in submitting claims using the new CMS-1500 (02/12) claim form, we have revised our CMS-1500 toolkit to accommodate the updated version of the form. Download this toolkit, titled Claims submission toolkit for proper electronic and paper claims submissions.
This toolkit contains the latest information on electronic and paper claims submissions, a sample CMS-1500 (02/12) claim form, key fields, loop and data elements, and resources for finding additional information.
The NUCC has also published an updated 1500 Health Insurance Claim Form Reference Instruction Manual,which is available under the 1500 Claim Form tab on the NUCC website.
If you have any questions, please contact your Network Coordinator or Hospital/Ancillary Services Coordinator.
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