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Insurance Company Paper Claims Settings

Updated: 11/11/2020
Views: 7136

If you plan to submit claims in paper form, you can configure paper claim settings for an insurance company. See also the Kareo Guide to CMS-1500 02/12 form.

Navigate to Paper Claims Settings

  1. Click Settings > Insurance > Insurance Companies. The Insurance Companies window opens.
    Note: The Insurance Companies window is also known as the Enrollments Dashboard.
  2. Find the insurance company then click the insurance company name. The General tab of the Edit Insurance Company window opens by default.
  3. Click the Paper Claims tab.

Paper Claims Settings

  1. Select the appropriate settings for the insurance company.
    1. Insured Format: Leave as Default or click the drop-down arrow to select Medicare style to prevent information from printing in Boxes 4 and 7 and to print "NONE" in Box 11.
    2. CMS-1500 field 24g: Click the drop-down arrow to select Units (standard) or Minutes (typically only used for anesthesia related charges).
    3. CMS-1500 field 32b: Click to select or clear the selection for "Use Facility ID". 
      Note: When enabled, the Facility ID Number entered in the Service Location record populates Box 32b. This is typically only required if the service location has been assigned a unique Facility ID number by the payer. 
    4. Primary Billing Form: Select the CMS-1500 format that is required by this insurance company (as the primary payer on a claim) from the drop-down menu.
    5. Secondary Billing Form: Select the CMS-1500 format that is required by this insurance company (as the secondary or tertiary payer on a claim) from the drop-down menu.
      Tip_Icon.pngTip: Check with the payer if there is any uncertainty, but in most cases, the same form for both primary and secondary claims can be used.
    6. Under the Institutional Claim Format Settings, the Primary Billing Form currently only has one format; UB-04 Form
  2. Click Save.
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