In SimplePractice, you can generate CMS 1500 claim forms to submit electronically through the system, or download and print to submit outside the system.
In this guide, we'll cover:
Note: Before you create your first claim form, you'll want to make sure that you've entered all of your practice and client information accurately so this populates into your claim forms correctly. Refer to Getting Started Guide: Insurance for these steps.
How to create a CMS 1500 form
- Navigate to the client's Billing page
- Set the date range for the appointments you want to include on the claim form
- Click New > Claim/CMS 1500
- Review the auto-populated information on the claim and add or edit any fields necessary
- Click Save
When creating a claim from the client's Billing page, all appointments that took place during the selected date range will get included in the claim. This means that appointments with both the Self-Pay and Insurance billing types will be included on the claim. If you only want appointments with the Insurance billing type included in your claim, you can use our batch claim filing feature instead. See Creating batch claims to learn more.
Note: The layout that you see your new claim form in is for editing purposes. Once printed, your claim form will appear like a normal CMS 1500 form. For more information on auto-populating additional fields, see Auto-populating additional fields on claim forms.
How to print your CMS 1500 form
After saving your claim form, you can submit it electronically through SimplePractice, or download it to print.
To download and print your claim form, follow these steps:
- Click Download
- Select Download with form background if you want to generate the full, red CMS 1500 form as a PDF
- Select Download with form fields only if you want to only generate the data fields so you can print it onto a blank CMS 1500 form
Important: If you are downloading a secondary claim form, you will notice that the downloaded PDF does not match that of the claim form you see in SimplePractice. That is because certain boxes like 8 and 24 where you would enter the client's COB information are specific to SimplePractice and filing secondary claims electronically. These fields are not present when you download the claim as they are not required since secondary claims filed by mail usually are accompanied by a physical primary EOB.
Note: To submit your claim electronically instead, click the Submit button. Refer to Filing an insurance claim in SimplePractice to learn more about electronic claim filing.
Tips for printing your claim form
- When printing the claim form, make sure the printer does not scale the page or add margins.
- When printing the full claim form with the red background, make sure your red ink cartridge is full and the red background prints without any streaks or faded color.
- When printing the data directly onto a blank claim form, we recommend adding the blank claim form to your printer's main paper tray as opposed to an auxiliary paper tray.
- Remember that each printer is different — if your data fields don't print perfectly onto the blank claim form, you may have to adjust the way you load the blank forms in the paper tray.
We recommend reaching out to your insurance payer if you have questions about the requirements for submitting printed CMS 1500 forms.