How to File an HCFA 1500 Claim

Form HCFA-1500 must be filled out appropriately before sending it.

Medicare is a federally funded program that offers certain qualifying individuals health care benefits. Insurance companies that process Medicare plans need to differentiate between health care services covered by Medicare and other services that must be billed before applying Medicare benefits. Form HCFA 1500 accomplishes this purpose. The form has space to detail the type of care given to the patient and the type of insurance the patient has. Once the form is filled out, it must be sent to the appropriate agency.

Instructions

1. Review the form to ensure that all necessary information is listed. Scan the form and look for the word "REQUIRED" on each field. These fields must contain information.

2. Check that current terminology and coding is used on the form. Birth dates must be listed as eight digits in a "MMDDYYYY" format.

3. Mail the completed form to your state's Medicare claims division. This may be your state's Department of Health or a separate division. Contact your state's health department for the most current address to send the completed form. The agency will file your form.

References

• Health Insurance Claim Form HCFA 1500 Instructions
• Michigan Legal Aid: Filing Form HCFA 1500
• MaineCare Covered Services: Filing HCFA 1500

Resources

• HCFA 1500 Blank Form