Introduction: The details provided are meant to guide you in understanding the boxes or Item Numbers present on the CMS-1500 form and also gaining an understanding as to where in PrognoCIS the values come from.
There are 33 boxes in total on the CMS-1500 form, and categorically, they are 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 is explained with screenshots of the CMS-1500 form and PrognoCIS - highlighting the field or source that affects these fields.

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, and Other are the options displayed in CMS Box 1.

From PrognoCIS

Navigation Go to 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 the 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 the patient's Insurance Umbrella icon: (available from multiple locations) → Subscriber ID

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

Figure 1: Item No. 1a


ON CMS - 1500

Displays the 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 Go to the Patient menu → Register → First Name, Middle Name, Last Name. Refer to the figure.

Figure

ON CMS - 1500

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

Figure 1: Item No. 1a

From PrognoCIS

Navigation Go to the Patient menu → Register

The Date of Birth and Sex selected from the Patient Register screen are displayed in the Item No. 5 box of the CMS-1500 form. Refer to Figure 1

ON CMS - 1500

Displays the subscriber's name.

Figure 1: Item No. 4.

From PrognoCIS

Navigation Click the patient's Insurance Umbrella icon: (available from multiple locations) → 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; otherwise, depending upon the value selected from the Relation drop-down list, the name entered in fields such as First Name, Middle Name, and Last Name is displayed on the CMS-1500.
Note:

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

ON CMS - 1500

Displays the patient's address details such as street name and number, city name, state name, ZIP code, and patient's home telephone number.

Figure 1: Item No. 5

From PrognoCIS

Navigation Go to the Patient menu → Register → Address tab

The Date of Birth and Sex selected from the Patient Register screen are displayed in the Item No. 5 box of the CMS-1500 form. Refer to Figure 1


ON CMS - 1500

Displays the patient's relationship with the insured, i.e., a person or organization covered by insurance.

Figure 1: Item No. 6

From PrognoCIS

Navigation Click the patient's Insurance Umbrella icon: → Insurance pop-up → Relation drop-down list.

The patient's relationship with the insured selected from the Insurance pop-up 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, Employment Status, and Employer Name are either editable or not. For example, if the patient himself/herself is the insured, all the mentioned fields remain disabled. Refer to Figure 1

Figure 1: The Relation drop-down list as displayed on the Insurance pop-up.

ON CMS - 1500

Displays the 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 Go to the 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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, it indicates there may be other insurance primary to Medicare. Identify the primary insurance information in Item 11. The Place (State) box displays the state postal code. Refer to Figure 1

Figure 1: Item No. 10a-c

From PrognoCIS

Navigation Go to the Claims menu → Edit Claims → options: Work Comp Employment / Auto Accident / Other Accidents

And

Navigation Go to the Claims menu → Edit Claims → Injury button next to the option "Other Accidents" → click to open the Attorney/Insurance Adjuster pop-up.



ON CMS - 1500

Displays the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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 the 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 Go to the Patient menu → Insurance Umbrella icon: Subscriber ID → Vendors → Insurance → Claim Filing Code

The option selected from 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