The form is new cms 1500 claim form pdf used to bill Medicaid State Agencies. Please contact your State Agency for more details on Medicaid billing. Read the instructions below first.
The latest version of the original manual from the National Uniform Claim Comettee of how to complete the claim form 1500. This scanning technology allows for the data content on the form to be read and transferred into a format for automated processing by Medicare systems. The form fields, headings, and lines are rendered invisible to the scanner by use of what is commonly called “drop out” ink. The “static” form fileds are visible on the screen only.
They are for easy orientation while you are entering your medical claim. They will not print over your original CMS-1500 sheet. Only the information entered by the user will print out. THIS PRODUCT IS “AS IS”. WE DO NOT PROVIDE ANY SUPPORT FOR IT.
Make sure your Page Scaling is set to None. There are several things that can vary from computer to computer – operating system, browser, PDF reader, printer and printer driver, various settings. Try aligning your top left field on the PDF to the paper form by adjusting the margins of your print area from the settings. Then adjust your scaling if the rest of the fields are still off. Click on “Highlight Fileds” to display all fields that allow input.
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