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Auto-populating additional fields on claim forms

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 the following 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?

How to enable additional fields on the CMS 1500 form

Here's how to enable additional fields:

  1. Navigate to a client's page and click View/edit client info.
  2. Click the Billing and Insurance tab.
  3. Scroll down to the Insurance Claim/CMS Fields section.
     
  4. Select (or check) the Enable Additional Fields checkbox, as shown below. This will reveal entry fields for the additional CMS boxes.
  5. Fill out these fields to have this information auto-populated to all future claims created for this client.

Note: 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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