Auto-populating additional fields on claim forms

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When creating a claim form, you may want to auto-populate more fields than just the standard demographic, insurance, session, and provider information. 

SimplePractice can automatically fill out these additional fields on the CMS 1500 (HCFA) form:

Box 10. IS PATIENT'S CONDITION RELATED TO
Box 14. DATE OF CURRENT ILLNESS, INJURY, or PREGNANCY (LMP)
Box 16. DATES PATIENT UNABLE TO WORK IN CURRENT OCCUPATION
Box 17, 17a, 17b. NAME OF REFERRING PROVIDER OR OTHER SOURCE
Box 18. HOSPITALIZATION DATES RELATED TO CURRENT SERVICES
Box 20. OUTSIDE LAB and LAB CHARGES
Box 23. PRIOR AUTHORIZATION NUMBER
Box 26. PATIENT'S ACCOUNT NUMBER
Box 27. ACCEPT ASSIGNMENT?

To enable these additional fields go to the client's Edit Info page and click on the BILLING AND INSURANCE tab.

Click the Enable Additional Fields checkbox.

 

This will reveal entry fields for these additional CMS boxes.

Fill out these entry fields to have this information auto-populated to all future claims created for this client.

If you'd like these fields to auto-populate on claims for all your clients, just enable these Additional Fields for each client you create. 

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