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:
- Navigate to a client's page and click View/edit client info.
- Click the Billing and Insurance tab.
- Scroll down to the Insurance Claim/CMS Fields section.
- Select (or check) the Enable Additional Fields checkbox, as shown below. This will reveal entry fields for the additional CMS boxes.
- 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.