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Updated CMS-1500 claim form resources now available

July 31, 2015

As previously communicated, Independence only accepts the updated version of the 1500 Health Insurance Claim Form (CMS-1500 claim form). The current version (02/12), which went into effect in January 2014, accommodates reporting needs for ICD-10 and aligns with data captured on electronic 837 transactions.

Updates were recently made to our Claims Submission Toolkit for Proper Electronic and Paper Claims Submissions. This toolkit was created to assist you in submitting claims using the CMS-1500 (02/12) claim form and contains the latest information on electronic and paper claims submissions, a sample CMS-1500 (02/12) claim form, key fields, loop and data elements, and resources for finding additional information.

In addition, the National Uniform Claim Committee (NUCC) recently released an updated 1500 Health Insurance Claim Form Reference Instruction Manual. To request more information, send an email to NUCC.

Note: CMS-1500 (02/12) claim forms can be purchased through office supply stores, local printing companies, or by calling the U.S. Government Printing Office at 1-866-512-1800.


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