The Record - BCBSM prepares for new CMS-1500 claim form

BCBSM prepares for new CMS-1500 claim form

When we reported in a web-DENIS message in July that the National Uniform Claim Committee had approved a new version of the CMS-1500 Health Insurance Claim Form, we didn’t have the transition timeline available to share with you. This article provides additional details about the transition to the new form.

Blue Cross Blue Shield of Michigan will begin accepting the revised CMS-1500 claim form (version 02/12) on Jan. 6, 2014. It will replace the current form (version 08/05) as well as the Michigan Status Claim Review Form.

The 1500 claim form is a paper claim form used by professional health care providers, while the Michigan Status Claim Review Form is used if a claim is rejected or if payment received is different from what was anticipated. The new claim form (version 02/12) can be used for both purposes.

You can continue to use the old paper CMS-1500 claims through March 31, 2014. See timeline below:

Before Jan. 6, 2014

Jan. 6, 2014, through March 31, 2014 (dual acceptance period)

As of April 1, 2014

Professional providers who don’t submit claims electronically should use the 08/05 version of the CMS-1500 claim form and the Michigan Status Claim Review Form.

Providers can submit either the 08/05 version or the Michigan Status Claim Review Form, or the 02/12 version of the new CMS-1500 claim form.

Providers should only submit the 02/12 version of the CMS-1500 claim form. The Michigan Status Claim Review Form is discontinued.

Approximately 18 fields have changed on the new form. (See draft of new form below.) Most include changes to the names on certain boxes, instructions for completing the information in specific boxes or the number of spaces allotted for diagnosis codes.

To help you prepare to use the new version of the paper claim form, we will include line-by-line instructions for completing it in the Claims chapter of our online provider manual beginning Dec. 1, 2013. (The Claims chapter of the manual will include two sets of instructions for completing CMS-1500 claims — one for each version — until April 1, 2014.)

You’ll be able to order the new form (version 02/12) after Jan. 1, 2014, by using the Blue Pages Directory on web-DENIS. We’ll provide additional details in the January Record.

For more information, contact your provider consultant or visit NUCC.org. The site includes instructions for completing the form.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2012 American Medical Association. All rights reserved.