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Video instructions and help with filling out and completing Free cms 1500 form filler software
Hey everyone for this week's activity we're going to be completing the CMS 1500 and the UB for claims forms so you have the information that you need listed in the activities and there's also a document that I added under the handouts tab that has the patient data table in the provider data table located - in the handouts portal of unit 10 so I'm not going to completely fill out all of the information on the two forms that we're completing but I do at least want to get you started so if you take a look at the UB for one of our first examples is with Abby Addison so essentially all of the different data fields on the you before in the CMS 1500 have specific information entered into each of these you can find more information about what is entered into each and every field in these step-by-step directions for completing there's tips for completing the CMS 1500 form and also completing the ubo for claims form found under handouts as well so back to the ubo for I have an area here in section 8 sections 1 in looking at those tips for completing the two claims forms you'll see that the prime pras information is completed here we have room for the patient's medical record number in field 3b looking at our information we see that Abby's medical record number is listed so in our tips for completing one of the CMS rules for completing both the ubo for in the CMS 1500 form is that you have to use all cap so make sure your all caps button is on on your computer and you can enter Abby's medical record number into field 3b patient name is completed in field eight a patient address you'll find that in the patient data table as well as the birth date we know that Abby is a female we do have the admission date as March 7th so that information will be entered into field 12 condition codes you'll find them from more information about the condition codes in the step-by-step directions so take a look at those we don't have all of the information available to completely fill out this form to 100% accuracy so I'm not expecting to have this form and every single field completed with all of the information because you just don't have it so do the best that you can our line items start under descriptions in our first line item 4a d a B is room in board so I'm typing that in we have our service dates which is the date of the encounter our information gives us the total cost for those services so as you can see I'm just abstracting the information from the instructions for completing the exercise and I'm filling in the appropriate fields for the CMS 1500 form essentially you're doing the same thing you'll have the patient's health insurance.