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HCFA Forms

HCFA stands for Health Care Financing Administration. The HCFA 1500 is the form used to process government health care claims. It is not something normally seen by the patient, but is rather the behind-the-scenes paperwork that gets sent off to insurance companies. These forms have all the information that the claims processing center would need to make sure that the insurance is paid properly.

  1. Function

    • HCFA forms are used to process claims for Medicare, Medicaid and other government programs with regard to payments. They are also used by some private insurance companies for the same purpose. Doctors' offices will submit the forms to the proper insurance entity, where they are entered into the computer system under that patient's account. Pay codes are entered and processed by the system to ensure that correct payments are made based on coverage.

    Features

    • The forms can be processed for various insurance plans and have a check box for each type. They have a section for patient information, physician information, insurance and charges. HCFA forms are pretty simple to follow, and there are also explanations and instructions on the back of the form for certain situations.

    Benefits

    • Having a single form to submit all claims to various insurance agencies makes the process easier for the doctor's office. If all claim forms are the same, then there is no need to hunt for where to put certain information. It is good for the receiving end, such as Medicare claims processing. With all the forms coming in being an HCFA form, a claims processor knows just where to look to get certain information.

    Types

    • The forms are set up for either laser or track fed printers. The laser printers will print off the appropriate number of copies for each patient. The track fed copies are all together and, with the use of carbon copying, will print all copies at once.

    Warning

    • Filing a fraudulent claim on an HCFA form is punishable by civil or criminal law. You should ensure that all information is correct to the best of your knowledge when filling out the form and double check that information before sending it in.

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