Tips for Completing the CMS-1500 Claim Form

Tips for Completing the CMS-1500 Version 02/12 Claim Form FAILURE TO PROVIDE VALID INFORMATION MATCHING THE INSURED’S ID CARD COULD RESULT IN A REJECTION OF YOUR CLAIM. Tips for Completing the CMS-1500 Version 02/12 Claim Form Page 1 of 12 Enter in the white, open carrier area the name and address of the payer to whom this claim is being sent. ................
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