Medicare has specific requirements for how they want claims submitted on the HCFA 1500 Claims forms. Below we have outlined the areas where you can enter the necessary information to satisfy these Medicare specific requirements.
Setting Up Medicare As An Insurance Co.
Medicare and HCFA 1500 - Box 11
Initial Treatment Date
Medicare requires the patient's initial treatment date to appear on the HCFA 1500 Claims form, and advises that this is to go in Box 14 of the HCFA Claims form. However, when submitting claims through ChiroFusion and Office Ally, this needs to be setup differently to transmit to Medicare properly.
Essentially, it is Box 15 that is representative of the 'Initial Treatment Date' and when used with Qualifier 454, it will be sent in the correct format and still meet the requirement that Medicare indicates as being 'Box 14'. It is the Qualifier that matters most and the proper format for Medicare patients is as follows:
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Box 14: Onset Date of Ailment Illness and Qualifier 431
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Box 15: Initial Treatment Date & Qualifier 454
See image below:
The above outline is in reference to Medicare standards in part and there may be other applicable requirements that can vary from case to case. We advise contacting Medicare directly when verifying Provider requirements/details for claims filing.