Intoduction: The details provided are meant to guide you in understanding the boxes or Item Numbers present on CMS-1500 form and also gaining understanding as to from where in PrognoCIS are the values coming from.
There are in all 33 boxes on the CMS 1500 form and categorically it is being considered in three parts:
Items 1-11 are Patient and Insured Information.
Items 11a-13 are Patient and Insured Information.
Items 14-33 are Provider of Service or Supplier Information.
Each of these items are explained with screenshots of CMS 1500 form and PrognoCIS - highlighting the field or source that affects these feilds.

Items 1-11 - Patient and Insured Information

1st Line - Patient Name
2nd Line - First line of address
3rd Line - Second line of address, if necessary
4th Line - City, State (2 characters) and ZIP Code

On CMS - 1500

Medicare, Medicaid, TRICARE, CHAMPVA, Group Health Plan, FECA, Black Lung, Other are the Options displaying on CMS Box 1.

From PrognoCIS

Navigation Goto Settings → Configuration → Vendors → Insurance → Claim Filing Code

The Option selected from the Claim filing Code drop-down list determines the option that is pre-selected in the CMS-1500 form.


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

Navigation click Patient's Insurance Umbrella icon: (available from multiple location)→ Subscriber ID

The Subscriber ID entered on the Insurance popup is displayed as Insured's ID. Number, in the CMS-1500 form. Refer to figure 1a

Figure 1: Item No. 1a


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 2

From PrognoCIS

Navigation Goto Patient menu → Register →First Name, Middle Name, Last Name Refer to figure

Figure

ON CMS - 1500

Displays Patient's eight-digit birth date (MM | DD | CCYY) and sex..

Figure 1: Item No. 1a

From PrognoCIS

Navigation Goto Patient menu → Register

Date of Birth and Sex selected from the Patient Register screen is displayed in the Item No. 5 box of the CMS1500 form. Refer to figure 1

ON CMS - 1500

Displays Subscriber's name.

Figure 1: Item No. 4.

From PrognoCIS

Navigation click Patient's Insurance Umbrella icon: (available from multiple location)→ Subscriber Name (First Name, Middle Name, and Last Name)Refer to figure 1

If the Subscriber (the person who is covering the patient as a dependent under his or her health Insurance plan) is the patient himself or herself then on the CMS 1500, the Patient's name is displayed else depending upon the value selected from the Relation drop-down list the name entered in the fields such as First Name, Middle Name, and Last Name is displayed on the CMS1500.
Note:

  Only if the values such as Spouse, Parent, Legal Gaurdian, Other, and Life Partner is selected from the Relation drop-down list, is the fields related to Subscriber details (such as First Name, Middle Name, Last Name, Sex, DOB, Same as patient option, address button, SSN number , and Employer Status drop-down list) are enabled for input.
  Depending on the property, workcompins.relation.employer.mandatory for worker's comp payer, Name of the employer is printed

ON CMS - 1500

Displays Patient's Address details such as Street name and No.; City name; State Name; Zip code; and Patient's Home Telephone No..

Figure 1: Item No. 5

From PrognoCIS

NavigationGoto Patient menu → Register → Address tab

Date of Birth and Sex selected from the Patient Register screen is displayed in the Item No. 5 box of the CMS1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's relationship with the Insured i.e. a person or organisation covered by Insurance.

Figure 1: Item No. 6

From PrognoCIS

NavigationGoto Patient's Insurance Umbrella icon: → Insurance popup → Relation drop-down list.

Patient's relation with the Insured selected from the Insurance popup is displayed on the CMS 1500 Form, Item 6. box. Depending upon the value selected in the Relation drop-down list, the fields, First Name, Middle Name, Last Name, DOB, same as Patient option, address button, SSN number, Employment Status, and Employer Name are either editable or not editable. For example, If the patient himself/herself is the Insured then the value, all the mentioned fields remains disabled. Refer to figure 1

Figure 1: Relation drop-down list as displayed on the Insurance popup.

ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Register → Address tab → Refer to figure 1

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form.



ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

The selected YES or NO options indicate whether employment, auto liability, or other accident involvement applies to one or more of the services described in item 24. If YES is selected for any item, indicates there may be other insurance primary to Medicare. Identify primary insurance information in item 11. The Place (State) box displays the State Postal code. Refer to figure

Figure 1: Item No. 10a-c

From PrognoCIS

NavigationGoto Claims menu → Edit Claims → options: Work Comp Employment/Auto Accident/Other Accidents

And

NavigationGoto Claims menu → Edit Claims → injury button next to option,Other Accidents → click to open Attorney/Insurance Adjuster popup



ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1


ON CMS - 1500

Displays Patient's Medicare Health Insurance Claim Number (HICN) (Insured's ID Number) whether Medicare is the primary or secondary Payer.

Figure 1: Item No. 1a

From PrognoCIS

NavigationGoto Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The Option selected in the Claim filing Code drop-down list Refer to figure 2 determines the option that is pre-selected in the CMS-1500 form. Refer to figure 1