New HCFA 1500 Claim form – New Version 02/12

The version 02/12 1500 health Insurance Claim form has received final approval from CMS (Centers for Medicare & Medicaid Services) New 1500 claim form (New Version 02/12) is revised form accommodates reporting needs for ICD-10 and aligns with requirement in the Accredited Standards Committee X12 (ASC X12).

What is the deadline for New 1500 Claim form – New Version 02/12

The Centers for Medicare & Medicaid Services (CMS) announced in the CMS Medicare Learning Network on June 27, 2013 that their tentative timeline for implementing the 02/12 1500 claim form is as follows:

January 6, 2014: Medicare begins receiving and processing paper claims submitted on the revised CMS 1500 claim form (version 02/12).
January 6 through March 31, 2014: Dual use period during which Medicare continues to receive and process paper claims submitted on the old CMS 1500 claim form (version 08/05).
April 1, 2014: Medicare receives and processes paper claims submitted only on the revised CMS 1500 claim form (version 02/12).

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What is QMB / MQMB stands for?

In Medical billing or Healthcare industry The term QMB stands for Qualified Medicare Beneficiary & MQMB stands for Medicare Qualified Medicare Beneficiary. The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria: Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits. Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client. QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition ...

Rejection Procedure note qualifier is missing

Need to check the Charges tab and double click on the Procedure Code line to open up the Charge Entry window. There is a Notes section on the right hand side. If there is a note typed, we need to select the type. Need to select field and select the appropriate type of note you are sending. Save the changes made Check all the procedure if submitted many procedure. Save the visit again and submit the claim.

Novitas Address for mailing paper claims

According to Novitas “ Effective 04/15/2014, paper claims that were submitted to the old Novitas Solutions mailing addresses are no longer being forwarded by the postal service. The 1500 claim forms are being mailed back to the provider and will need to be resubmitted to the correct mailing address” Herewith we have enclosed the Novitas mailing address Jurisdiction H (JH) includes Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas, Indian Health and Tribal facilities as well as Veterans Affairs. General Mailing Address Novitas Solutions Attn: (dept or function name or specific person) 2020 Technology Parkway, Suite 100 Mechanicsburg, PA 17050 Addresses for Claims and Development Responses This section contains the addresses for submitting initial claims and responding to development requests for additional information. Part B Claims Novitas Solutions Attn: Part B Claims PO Box XXXX (replace the Xs with the PO Box number from ...

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