CMS 1500 Form
Answered
Hello, I am preparing to open up my private practice in a few weeks and want to make sure I am prepared to accept insurance. I am credentialed on several major insurance panels and did this when I was working at another agency. I have acquired an EIN and NPI for my LLC and also have myself as the rendering provider where I use my SS and provider NPI. This is all very confusing as I am not sure where I need to put these on the CMS 1500 form. Can anyone give me some clarification on how to make sure I have the form completed correctly?
Thank you,
Kandi
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Hi Kandi, as long as all of this information is entered in the right place in SimplePractice, you should be good to go! SimplePractice auto-fills claim forms for you, so you don't have to worry about putting anything in the wrong box. I'd recommend checking out our Getting Started with Insurance Billing guide here to make sure you're all set up to start billing insurance: https://support.simplepractice.com/hc/en-us/articles/115003539526-Getting-Started-Guide-Insurance
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Hi Gillian,
From my understanding Kandi needs to use an EIN for some insurances and an SSN for others.
I do not see where both an EIN & SSN can be entered and then be selected based off of the insurance the claim is being submitted to. IS this correct?
Khandi, When you worked at the other agency, were claims submitted under their EIN or your SSN? IF it was their EIN You may not be credentialed with them as an individual provider. IF you were submitting claims while at the other agency with your SSN, then you need to contact the insurance companies and go through the process to update your service locations address and billing address and update your SSN to your new EIN. This way you can submit all claims with your EIN and you won't have to deal with this issue. Insurance companies are very fast at updating information if you are changing your tax id. FYI, re-credentialing (if it is that time) has nothing to do with the information that the claims department has. They are two different departments and must be dealt with individually (unfortunately).
I hope this helps
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Sarah, you should be able to continue billing under your EIN and address until it's updated in each payer's systems. If you have any "accepted" enrollments with insurance payers in SimplePractice, your updated NPI/EIN needs to be updated on the enrollment once the insurance company updates in their system as well.
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