Ifomu leSimangalo se-CMS 1500

Sebenzisa inguqulo ye-02/12 yokukhokha kokumangalelwa odokotela nabahlinzeki

I-CMS 1500 yi-inkino ebomvu ephepheni elimhlophe lokumangalelwa kwephepha elilisebenzisiwe odokotela nabahlinzeki ngezinkokhelo zokufaka isicelo. Nakuba lakhiwa yi-The Centers for Medicare ne-Medicaid (i-CMS), seliye ifomu elijwayelekile elisetshenziselwa bonke abathwali bomshuwalense. Kusukela ngo-Ephreli 1, 2014, i-version ebuyekeziwe ye-02/12 yiyona kuphela eyamukelwa yi-Medicare. Inguqulo endala 08/05 ayisasebenzi.

Ubani Ongayenza Izimangalo Zebhilidi Esebenzisa i-CMS 1500?

Noma yikuphi umhlinzeki ongenazikhungo kanye nomphakeli angasebenzisa i-CMS 1500 ngezinsolo zezokwelapha zokukhokha.

Amathiphu okulungiselela ifomu leSimangalo se-CMS 1500

Imiyalo eningiliziwe ingatholakala ku-www.cms.gov noma ku-www.nucc.org

Ukubuyekezwa kwe-CMS 1500 - Inguqulo 02/12

Ngempumelelo ngoJanuwari 6, 2014, i-version ebuyekeziwe (02/12) yefomu ye-CMS 1500 ivunyelwe ukusetshenziswa. Ifomu le-CMS le-1500 elibuyekeziwe (i-version 02/12) lakhiwe ukuze lihambisane nezinguquko zesakhiwo ekukhokheni kwe-elektroniki kusuka ku-version 4010 kuya ku-5010 ka-837P kanye nokushintshwa kusuka ku-ICD 9 kuya ku- ICD 10 .

Leli fomu laqaliswa ngoJanuwari 6, 2014. Ngomhla ka-Ephreli 1, 2014, abahlinzeki bangasebenzisa kuphela ifomu elibuyekeziwe le-CMS 1500 (version 02/12). Noma yimaphi amasheya asele ka-08/05 akufanele asetshenziswe.

Umehluko Phakathi kwe-version 08/05 no-Version 02/12

  1. Inhloko: uphawu lwama-rectangular lushintshwa ngekhodi ye-QR.
  2. I-Field Locator 1: I-TRICARE CHAMPUS ithathelwe indawo yi-TRICARE; I-SSN ithathelwe esikhundleni nge-ID #
  3. Indawo Yendawo Yendawo 8: ISITATIMENDE SEMPATIENT sashintshwa yi-RESERVED FOR NUCC USE
  4. Indawo Yendawo Yendawo 9b: OKUNYE UMTHETHO WOKUPHILWA KWEZOKUPHILA, UKUSEBENZISWA KWE-SEX kwafakwa esikhundleni se-RESERVED FOR NUCC USE
  5. Indawo Yendawo Yendawo 9c: IGAMA LOMSEBENZI NOMA ISIKOLO sashintshwa yi-RESERVED FOR NUCC USE
  6. Indawo Yendawo Yendawo 10d: UKUSETSHENZISWA KWEZOKUSEBENZISWA KWEZINDAWO ZOKUSEBENZISWA KWEZINDLELA kwashintshwa ngamakhodi e-CLAIM (Okukhethwe yi-NUCC)
  7. Indawo Yendawo Yendawo 11b: IGAMA LOMSEBENZI NOMA ISIKOLO sithathwe esikhundleni se-ID YOMTHETHO WOKUKHALWA (Okushiwo yi-NUCC); umugqa onamachashazi wanezelwa ukuze kusetshenziswe isitifiketi samadijithi amabili
  8. Indawo ye-Field 14: UMHLA WESIKHATHI (umcibisholo obomvu) ILLNESS (isibonakaliso sokuqala) NOMA INJURY (engozini) OKUTHI UKUQALA (LMP) kwashintshwa ngo-DATE OF CURRENT ILLNESS, INJURY, noma PREGNANCY (LMP); I-QUAL yanezelwa, futhi umugqa onamachashazi wanezelwa ukuze kusetshenziswe isitifiketi samadijithi amathathu
  9. Indawo Yensiza 15: UKUBA UMPATENTI AKHENZEKA KANYE NOMA UKUPHILA OKUNYE. NOMA UMHLA WOKUQALA wangena esikhundleni se-OTHER DATE; I-QUAL yanezelwa, futhi umugqa onamachashazi wanezelwa ukuze kusetshenziswe isitifiketi samadijithi amathathu
  1. I-Field Locator 17: umugqa onamachashazi wanezelwa ukuze kusetshenziswe isitifiketi samadijithi amabili
  2. Indawo Yendawo Yezingu-19: UKUSEBENZISWA KOKUSEBENZISWA KWEZINDAWO ZOKUSEBENZISWA KWEZINDAWO KUNYE KWENYAKA YAMANYE NOKWENZEKA NGOKWENKULWA KWEMALI
  3. Indawo ye-Field Locator 21: I-ICD Ind. Yanezelwa futhi umugqa onamachashazi wanezelwa ukuze kusetshenziswe isitifiketi samadijithi angu-1; 8 imigqa eyengeziwe yanezelwa amakhodi okuxilongwa; Amalebula wendlela yokuxilongwa ikhodi yashintshwa kusukela ezinombeni kuya ku-alphas
  4. Indawo Yendawo Yezingu-22: Ukubuyiswa kwe-MEDICAID kwafakwa esikhundleni se-RESUBMISSION
  5. I-Field Locator 30: I-BALANCE DUE ishintshwe ngu-Rsvd ye-NUCC Sebenzisa