Health Forms and Systems, Inc. - HCFA|CMS 1500, HIPPA, UB04, Superbills

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Featured Products

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HCFA Claim Forms
UB04 Claim Forms
Patient Charts & Filing Systems

HCFA Claim Forms

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Revised HCFA|CMS
1500 Claim Forms

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Old HCFA 1500 Claim Forms

Important Notice Regarding the
Revised CMS-1500 Form

As part of our continued effort to provide you with up-to-date information on governmental legislation mandates, we would like to inform you that CMS has announced there are incorrectly formatted versions of the newly-revised CMS forms being sold by print vendors.

Please note: Revised Effective Data Notice: As of recent, CMS (Medicare) has announced the following: July 1, 2007, as the effective date for accepting only the revised CMS1500 (08/05) claim forms. May 23, 2007, as the effective date for accepting only UB04 claim forms. The healthcare industry consists of many payers (insurance companies) who will continue to accept both old and new claim form versions. We plan to continue offering both versions until the majority of healthcare providers and payers are using the revised CMS1500 (08/05) and UB04 claim forms.

Rest assured that Health Forms & Systems Forms are 100% compliant to CMS specifications.

OLD VERSION (12/90)
Contains "Approved OMB-0938-0008 FORM CMS-1500 (12-90)" on the bottom of the form (typically on the lower right corner) signifying it to be the December 1990 version.

REVISED VERSION (08/05)
Contains "Approved OMB-0938-0999 FORM CMS-1500 (08-05)" on the bottom of the form signifying it to be the August 2005 version.

Revised HCFA|CMS 1500 Questions & Answers

When must I convert to the new form?

Not before 10/1/06 and no later than July 1, 2007.

I currently use the bar-coded HCFA form. Will I be able to order the new form in barcode?

No, the new form will only be available as a non-bar coded form.

Will I be able to use the left window envelope with the new form?

No, the NUCC has set up the form so that the out-going address must be printed on the upper right corner of the form. Therefore, only right window envelopes will work.

Will the new forms be the same price as the old forms?

Yes.

For further information, visit the National Uniform Claim Committee.
National Uniform Claim Committee (NUCC) Web site

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UB04 Claim Forms

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The National Uniform Claim Committee (NUCC) announces the approval of the UB04 Billing Claim Form as the replacement for the UB-92.

Why is it changing? The UB04 contains a number of improvements and enhancements that include better alignment with the electronic HIPAA ASC X12N 837-Institutional Transaction Standard. The New UB04 paper billing form will be able to accommodate the reporting of the National Provider Identifier (NPI) Number. The NPI will be a single provider identifier, replacing the different provider identifiers healthcare systems currently use for each health plan with which you do business. The NPI Identifier, which implements a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), must be used by all HIPAA covered entities, which are health plans, healthcare clearinghouses, and healthcare providers.UB04 timeline:

March 1, 2007 - Health plans, clearinghouses, and other information that support vendors should be ready to handle and accept the new UB04 form and data set.

March 1, 2007 - May 22, 2007 - Providers can use either the UB04 or UB92 forms/data set specifications.

May 23, 2007 - The UB92 is discontinued; only the UB04 forms and data set specifications should be used.

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Patient Charts & Filing Systems

We offer a complete line of patient charts, X-ray jackets, chart index dividers, color coding labels and more. Please call for a quote on any type of chart or chart system. Ask for our free catalog that will show you patient chart solutions that work for you!

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