Part of the requirements for the new 1500 form is the usage of the NPI.  If you have not yet obtained an NPI, we highly recommend that you begin the application process.  The NPI will be required on all electronic claims beginning May 23, 2007.  Medicare and other payors are starting to accept them now.

Before beginning the application, we recommend reviewing the application to make sure that you have all the required information before starting.  You can download the form from www.instacode.com/ftp/pub/NPI-application.pdf.

Your application can be made by:

1. mail  - complete the downloaded form and follow the instructions

2. on the web at nppes.cms.hhs.gov

Medicare has created a document to help you understand the NPI.  You can download a full MedLearn Matters document from www.instacode.com/ftp/pub/NPI-Medlearn.pdf.
 

Here are some commonly asked questions about the new 1500 Health Insurance Claim form.

Is this the same form as the CMS-1500?

YES and NO.  Officially, the proper name is now the 1500 Health Insurance Claim Form.  It is approved by government agencies, such the Centers for Medicare and Medicare Services (CMS), but it is not their form.  Hence, the former titles of “HCFA-1500”  or “CMS-1500” are now obsolete.  As with any change, it takes awhile for common expressions to be incorporated into daily usage.  With this opening paragraph, perhaps we can adjust sooner, rather than latter.  It will probably be just the “1500 Claim Form”,  “1500 HIC”, or the “1500”?

How can we tell them apart?

It is easy, and at first glance. The old CMS-1500 had big black bar codes on the top left.  They are gone.  Now there is just a simple clean rectangular box with “1500” inside the box.

Why do we need a new 1500 form?

Because you want your claim to get paid and not rejected. The implementation of the new National Provider Identifier (NPI) makes it crucial to have better reporting capabilities.  The old CMS 1500 claim form hasn't been updated in 17 years.  It simply became inadequate for today’s needs.

What was changed?

For a summary report of all that was changed on the 1500 form, click here.  If you would like to read a detailed article about the form and its changes, visit our news website www.instacode.net.

Who needs to be using the new 1500 form?

Anyone who does billing either by paper or electronically.   Those who send their data to an Electronic clearing house need to send the claim data in the new 1500 format.

When can I start using the new 1500 form?

Officially, any time after Oct 1, 2006.  

When must I start using it?

You must use the new 1500 exclusively by April 1st, 2007. That is the "set in stone" deadline for everyone (providers and payers). 

How do I know when my insurance payer is ready for them?

Good payers will advise you.  But if they do not, you need to ask them for their acceptance date.  We expect that most will be ready and operating by January 2007. We recommend waiting until their "deadline" date and not necessarily their "acceptance" date to ensure that your claims are processed correctly.

I heard that Medicare and others are accepting the new 1500 forms now.  Shouldn't I be using them now?

No. Just because a payer is accepting the new 1500, does not mean that it is required.  This is actually a testing period for them.  Of course, if you like being the guinea pig, submit claims with the new forms early on.  However, why not wait awhile, just to make sure the bugs are worked out of the system.  We recommend starting in January.

Where can I get the new forms?

We carry the new claim forms.  You can purchase them in our online store.  Many other medical supply vendors also carry them.

What about my old forms?

You can use them until March 31st, 2007.   Don't throw them away yet.  You can still submit claims using the old form, up until April 1, 2007 for some third-party payors.  Obviously, they can also be used as receipts for non-insurance (cash) patient encounters.  And lastly, if it is long cold winter, have a nice bonfire.

Will there be problems in this transition?  

Of course.  For example, we have received notification that if you do use the new form, you need to make sure that you include your previous UPIN and/or GRP # on the form in addition to the NPI to avoid problems in processing your claim.  If you plan on submitting claims on the new form, see our news article for more information about this notice.

Do I really need to know the various starting dates for our payers?

It could be very helpful. Submitting a claim on the new form when they are not ready could delay payment.
 

Will my SOFTWARE work with the new 1500 form?

No.  All software programs for printing onto the old CMS 1500 (HCFA 1500) claim form were designed long before HIPAA, the NPI and new 1500 Claim Form.   Any software will need to be updated, in order to print onto the new layout.

Here are some commonly asked questions about InstaClaim  as it relates to the new 1500 claim form.

Will my version of InstaClaim work with the new 1500 form?

No.  All prior versions to 3.0 will become obsolete as of April 1st, 2007.  They were designed long before the NPI and the new 1500 form.  A summary report of the changes and enhancements is coming soon.

Will InstaClaim version 3.0 print on either the old or new 1500 forms?

Yes.  Version 3.0 will print on either form.  It has a new insurance payor section which allows you to select which form a carrier is using.  During this transition period, period until April 1st, you can send each payer the 1500 version that they want..  Additionally, you there are carrier specific settings that will allow you to print decimals or dashes.

I just bought InstaClaim this year.  Do I have to buy an upgrade?

Yes, if you want to use the new 1500 form and get paid.

What’s the cost for the new VERSION 3.0 upgrade?

We have always been known for quality that is affordable.  Your upgrade pricing will be based upon your past purchase date.  

You will receive mail notification of your special renewal price.  Watch your mail for your EXPRESS RENEWAL.

Does InstaClaim do patient billing?

No.  Patient billing generally is part of more costly Practice Management System (PMS).  There are many wonderful systems out there already.  Each with their own unique personality.  Before you purchase any program, we recommend you get a trial version and make sure that it fits your personality. No.  InstaClaim is designed only for completing the 1500 HIC. It also does basic summaries of charges and payments for the month.  However, for patient billing and accounts receivable management, offices typically invest in a comprehensive and more costly Practice Management System (PMS).  There are many good and wonderful PMS programs available.  Each has their own unique qualities and features.  Before you purchase any program, we recommend you get a trial version and make sure that it fits your personality and needs.

If we have a good Billing system do we need InstaClaim?

Perhaps.  Interestingly, one InstaClaim customer has a very large Practice Management System, but it is very difficult to reprint a claim or create a claim for just one charge to re-bill.  They use InstaClaim when they need to re-submit part of a claim or do a reprint.

Does InstaClaim have a code lookup feature?

Yes, you can do a search for a diagnosis code or a procedure code.  However, because each practice has their own specific set of codes, we do not "pre-load" a set of codes in the software.  Instead, we created an "import" feature in the [Settings & Tools] which allows you to import your own list. 

Will the new InstaClaim VERSION 3.0 do electronic billing?

No, but it is coming soon.  We are now working with various electronic clearinghouses. This would make it possible to send some or all of your claims to them.  Alert… if you do electronic billing, you must abide by all the HIPAA rules and regulations and be 100% HIPAA compliant.  We do have HIPAA guidelines and forms available at our eStore to help with any transition

We are a small office. Can we download into QuickBooks?

That possibility is coming soon in 2007.  Many have asked for a basic billing and accounting program.  The Quick Books module fill those basic needs of many small offices.

I am interested in the new InstaClaim - Version 3.0.  Can you let me know when it is ready?

It is scheduled for late November.  For immediate notification when released, send an email to . Enter INSTACLAIM VERSION 3.0 NOTIFICATION in the subject line.  If you also want snail mail notification, include your regular mailing address with your email.

We're here to help. If you have other questions, please let us know and we will get an answer to you just as soon as we can.
Send an email to and let us know your question.
InstaCode Institute
2314 West 8900 North
Dammeron Valley UT 84783-5202