paper claim CMS 1500 printing tips

Claims should be completed accurately to ensure proper claim adjudication. Remember the following:

Complete an original CMS-1500 claim form.
No photocopied claims will be accepted.
Use blue or black ink.
Be sure the information on the form is legible.
Do not use highlighters.
Do not use correction fluid or correction tape.
Ensure that names, codes, numbers, etc. print in the designated fields for proper alignment.
Claim must be signed. Rubber signature stamps are acceptable.
No multiple page claims may be submitted.
The six service lines in Locator 24 have been divided horizontally to accommodate submission of supplemental information along with NPI and other identifiers such as taxonomy codes or legacy identifiers. The top, shaded portion of each service line is for reporting supplemental information (i.e., NDC code). It is not intended to allow the billing of twelve service lines. Each procedure, service, drug, or supply must be listed on its own claim line in the bottom, un-shaded portion of the claim line.