Final answer:
The CMS-1500 form is the standard claim form used by non-institutional providers or suppliers to bill Medicare, Medicaid, and other third-party payers for healthcare services provided.
Step-by-step explanation:
The standard claim form used by non-institutional providers or suppliers to bill claims is known as the CMS-1500 form. This form is utilized by healthcare professionals and suppliers to submit claims to Medicare, Medicaid, and various other third-party payers for reimbursement. It includes fields to provide detailed information about the patient, provider, services rendered, and the costs associated.
It requires precise completion, including the National Provider Identifier (NPI), diagnosis codes, procedure codes, and charges for each service. Coding must be accurate to reflect the services provided and diagnoses made. This form is critical for the billing process, ensuring that healthcare providers are paid for their services.
Payers such as Medicare and Medicaid rely on the accurate completion of CMS-1500 forms to process claims efficiently. Electronic submission of claims via the Electronic Data Interchange (EDI) has become common, but paper CMS-1500 forms are still accepted and used frequently.