NHIC, California’s Medicare carrier, has informed CMA that it will, despite previous reports to the contrary, be able to process claims submitted on incorrectly formatted CMS-1500 forms while physicians are obtaining corrected forms.

As recently reported in CMA Alert, the Centers for Medicare & Medicaid Services (CMS) earlier this month announced it would continue accepting the old CMS-1500 claim forms past the April 1 deadline because of formatting errors in some of the new forms being distributed by the Government Printing Office and other vendors. The form was recently updated to accommodate the mandated National Provider Identifiers (NPIs).

Medicare contractors have been instructed to continue accepting the old form until future notice. The current target date is June 1.

The best way to identify badly formatted forms is to look at the upper right-hand corner of the form. If the tip of the red arrow above the vertically stacked word “CARRIER” is touching or close to touching the top edge of the form, then the form is not printed to specifications. There should be approximately a quarter of an inch between the tip of the arrow and the top edge of the paper on properly formatted forms.

Please note that this issue involves the paper claim form only and does not affect the NPI implementation date. On May 24, physicians who are covered by HIPAA will be required by federal law to use their new National Provider Identifier (NPI) on claims and other electronic health care transactions. NPIs will replace UPINs and other payor-specific provider identification numbers.

To find out if your forms are formatted properly, click here.

Contact: CMA’s reimbursement help line, 888/401-5911.