1. HOLY COW ! What do you do? Your Doctor made 48 Diagnoses
HCFA forms have 4 spaces
HOLY COW !
What do you do?
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2. Print your HCFA (CMT 1500) claim form as usual.
Step 1
Print your HCFA (CMT 1500) claim form as usual.
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3. Step 2
After the claim form has printed place the first page back in your printer

4. Step 3
Now you must print the word “Supplement” on the first page of the HCFA claim form.
(like this)

5. If you have not already done so, go to www.HBTinstitute.com
Step 3A
If you have not already done so,
go to
Choose Doctor Forms
User Name = pay
Password = doctors
Find the “Billing & Collections” Section
Download “Copy this onto HCFA & attach Diagnosis form”
Step 4. After the billing has printed place the claim form back in your printer.

6. Print this form onto the front page of your HCFA-1500 claim form.
Step 3B
Open the file “Copy this onto HCFA & attach Diagnosis form” (it is a PDF file)
Print this form onto the front page of your HCFA-1500 claim form.
Step 4. After the billing has printed place the claim form back in your printer.

7. The first page of your HCFA form will look something like this.

8. Notice that box 21 line 4 lists “On File” as the 4th Diagnosis
Notice that box 21 line 4 lists “On File” as the 4th Diagnosis. You can customize your billing software to print this if you desire. You may also use the 4th line as you have in the past actually indicating a diagnosis code.

9. Step 4 You may now insert 48 Diagnosis Codes onto HCFA1500 (AKA CMT 1500) Simply staple a copy of the Diagnosis Form the doctor filled out to the CMT 1500 Form.

10. You have now given the claims adjuster every Diagnosis your Doctor has diagnosed. When you print this directly onto the CMT1500, it leaves nothing to the imagination of the claims adjuster.

11. Note: For proper billing, you will actually staple ALL these forms to the CMT1500
Symptoms
Diagnosis
Treatment Plan
Rivermead
Folstein
Epworth

12. Not only that, You will put a cover letter on your first med-pay claim
For more on that, see the training presentation titled:
Billing Med-Pay

13. Print your HICFA (CMT 1500) claim form as usual.
In Summary…
Print your HICFA (CMT 1500) claim form as usual.
Print the “supplement” on the form in box 21
Attach a copy of the patients Diagnosis Form (as well as all the others you will learn about in “Billing Medpay”
Send the whole package to the claims adjuster via Fax or Mail
Expect a check IN FULL soon.