CMS Response to Public Comments Received for CMS15000212

CMS Response to Public Comments Received for CMS-1500 (02-12)

The Centers for Medicare and Medicaid Services (CMS) received comments related to

CMS-1500 (02-12). This is the reconciliation of the comments.

Comment:

The Centers for Medicare and Medicaid Services (CMS) received a comment expressing concern regarding block 31 “SIGNATURE OF PHYSICIAN OR SUPPLIER

INCLUDING DEGREES OR CREDENTIALS. The commenter notes that the signature can be illegible causing claims to be recognized neither electronically nor by claims adjusters, resulting in denials of otherwise payable claims. The commenter further cites CMS Medicare manual instructions indicating the permissibility of the provider’s signature being on file instead of on the 1500 claim form. He recommends that the name of the block be changed to replace “signature” with “printed name.” On a different topic, the commenter recommends that the form be reviewed in terms of the information that providers must complete in order for a claim to process, as errors occur with missing mandatory information as well as superfluous additional information.

Response:

CMS thanks the commenter and notes that individual payers may use the

CMS-1500 (02-12) as best befits their practices. As an example, and as the commenter has pointed out, CMS accepts that a provider’s signature can be on file instead of physically present on the 1500 form. However, payers, providers, and other submitters are subject to any applicable Federal, State, and local laws relative to the information they must collect on a claim.

Regarding the commenter’s concerns that providers do not know what information to supply on a claim, CMS believes that it is the responsibility of individual payers and their providers to work together to understand the information to be supplied on a claim. However, CMS will refer the commenter’s concerns to the NUCC for consideration of the instructions they create in regard to the CMS 1500 form.

Comment:

CMS received a comment from the NUCC describing itself, its mission, and its history in developing the 1500 claim form; its recognition of the continuance of paper claim submission; and its work to revise the current form (08-05) to create CMS-1500 (02-12).

Response:

CMS thanks the NUCC for supplying the background which is essential to appropriately reviewing the current and revised forms.