Question

Which flat file format is used to bill physician and non-institutional services on a CMS-1500 claim form?

Answer 1

The flat file format used for billing on a CMS-1500 claim form is the ASCII format. This is a plain text file that healthcare providers use to submit claims electronically to insurance programs, including Medicare.

Step-by-step explanation:

The flat file format used to bill physician and non-institutional services on a CMS-1500 claim form is known as the American Standard Code for Information Interchange (ASCII) format. The CMS-1500 is a standardized form used by healthcare providers to submit claims for reimbursement from Medicare and other health insurance programs. When submitting claims electronically, the details of each item or service provided are formatted into an ASCII flat file, which is essentially plain text without any special formatting, to ensure compatibility across various systems. This file is then transmitted to the relevant payer (e.g., Medicare) for processing and payment.

Steps for Preparing a CMS-1500 Claim Form in ASCII:

1. Collect all necessary patient and service information.
2. Input the information into the practice management software.
3. Use the software to convert the claim information into the ASCII flat file format.
4. Submit the ASCII file to the insurance company or clearinghouse.