Filing a Paper Claim

Once your calls are coded, AngelTrack can fill out your paper CMS-1500 forms needed for insurers who refuse electronic claims.

Read the AngelTrack CMS-1500 Crosswalk to see how AngelTrack fills out the boxes on the form.


Blank CMS-1500 Paper Forms are Required

You must purchase blank CMS-1500 forms suitable for your printer. Not only does CMS not allow it, but the scanning machines require an exact print geometry and an exact tone of red ink. If you printed your own, not only is it illegal, but they would probably be rejected.

Be sure to purchase the latest version (02/12), not the older version (08/05). Both laser and inkjet versions of the form are available for purchase.

The CMS-1500 .PDFs generated by AngelTrack include the red parts of the form, but don't worry, the red parts are automatically omitted during printing. Only the claim data will print, in exactly the correct positions to line up with the boxes on the CMS-1500 form.

Viewed
What you see while editing
Viewed
What actually gets printed

Problem: The red background gets printed too

A few .PDF readers will accidentally include the red background when printing the form. This will cause it to be double-printed on your blank 1500 form.

This problem may be solved by any of the following:

If none of that helps, then you can direct AngelTrack to omit the red background from the CMS-1500 it generates. Unfortunately this makes it very difficult to perform last-minute edits to the form -- since you can no longer tell exactly which field is which -- but at least it will print correctly on your printer. Visit the Preferences page under Settings, and untick the ☑ Include the screen-only red background in generated CMS-1500 forms.

Problem: The printed text does not line up with the form

Your .PDF reader may try to be helpful, and resize the document in order to leave margins around the edges. This will shift the printed text so that it no longer lines up correctly with the boxes on the CMS-1500. The .PDF reader does not understand that you are printing on a pre-printed form that cannot be resized.

To solve this problem, access your .PDF reader's "Page Setup" or "Printer Properties" dialog. Tell it to print the document as "Actual size" or "Original size", rather than "Resize" or "Shrink to fit".

Print actual size

If still no luck, then try using the Google Chrome web browser to view and print your .PDFs, rather than a dedicated PDF-reader program. To do this, download a .PDF to your computer, then right-click it to open it using Chrome. If that works, then you can direct your computer to "Always use this app" for viewing and printing .PDF files.


Creating Batches of CMS-1500 Claim Forms

The best way to create CMS-1500 claim forms is with AngelTrack's batch system. The batch system allows you to manage a set of claims, marking or unmarking them all as "Claim Filed" payment events with one mouse click:

Claim batch UI

To create a batch, simply tick the checkbox next to all desired dispatches in an insurance queue. Then use the "Bulk Operations" box to create a claim batch of the selected runs. You will then be redirected to the Insurance Transmission Queue, where you can click the 1500 icon to download your new batch as a .PDF ready for printing.

When you click that icon, and get your .PDF, AngelTrack will automatically mark the batch as  Accepted , and furthermore will mark it to indicate that no electronic acknowledgements (X12.999 or X12.277CA) are expected.

If AngelTrack's clearinghouse uploader/downloader is active, then you will see an option to create your batch as "Claim batch (no upload)", which will prevent the uploader/downloader from uploading the batch to your clearinghouse.

Re-download / Re-print

AngelTrack can re-download the claim forms to you again later, should you ever need to reprint them. In the Insurance Transmission Queue, from the "Finished Batches" tab, simply click the 1500 icon for the desired batch.


Creating Individual CMS-1500 Claim Forms

If you prefer to not use AngelTrack's EDI batch system, then you can download individual CMS-1500 claim forms instead.

The insurance queues -- Filing, Appeal, Exception, and Master -- all offer to do this for you. Use the queue's filters to narrow down the range of calls, if necessary tick the checkbox beside each call you want, and then bulk export them using the ☑ CMS-1500 filled-out PDF format.

AngelTrack will combine the claim forms into a single .PDF, and then download it to you.

You'll need to code the calls first, of course, or else most of the CMS-1500 fields will be left blank.

Be sure to tell AngelTrack that you've filed the claims

Once you've verified that the .PDFs have printed properly, go back to the queue and use the "Record Claim Filed Events" bulk operation to tell AngelTrack that you filed the claims with the carriers.

This important task is explained in detail in the Detached Biller Guide.


Boxes 14 and 15, and Date Qualifiers

Boxes 14 and 15 contain certain dates, as well as the date-qualifier numbers that explain the meanings of those dates. Here are the meanings of the different date qualifiers:

Qualifier Meaning Box Source of Data in AngelTrack
439 Date of accident 14 "Accident" date specified in Coding; AngelTrack will auto-fill this date if it has the necessary data from a PCR Assessment record.
431 Date of symptoms 14 "Symptoms" date specified in Coding; AngelTrack will auto-fill this date if it has the necessary data from a PCR Assessment record.
454 Date of transport 15 Followup: Date/Time Transport Began if available, else Dispatch: Date/Time Activated

Box 14 has room for only one such date, so AngelTrack must choose which one to specify. It will send 439 if it knows that date, else it will try 431.

On the Coding page you can see which of these dates AngelTrack knows, and you can override them as necessary to please the carrier. Most carriers would like to receive 431, but as noted above, that requires your crews to input the date of symptoms in their assessments.

See also the AngelTrack CMS-1500 Crosswalk, to see how AngelTrack fills out the boxes.


Editing a Claim Form Before Printing

The CMS-1500 .PDF generated by AngelTrack contains live datafields, so that you can perform any final edits before printing. Unfortunately not all web browsers and .PDF viewers support this feature... but there are plenty of free alternatives that do.

Google Chrome and Microsoft Edge both allow you to hand-edit the contents of PDF form-fields, right on the screen, before printing.

That said, hand-editing of the .PDFs should be considered a last resort: because your changes will not be saved in AngelTrack, they will be lost if the .PDF is generated again. So if something in the generated .PDF is incorrect, correct it in AngelTrack's Coding page wherever possible. That way it will be saved in AngelTrack where it is safe, and no conflict will appear if the records are later audited.

Carriers that require box 24C "EMG"

CMS (Medicare) no longer uses box 24C ("EMG") for any purpose, because the service code itself already indicates whether or not the service was emergent. In other words, a carrier already knows that a BLS call is emergent because it is claimed as A0429 (BLS emergent) rather than A0428 (BLS non-emergent).

A small number of non-compliant carriers still require box 24C, so AngelTrack will place an 'X' into the box whenever you are claiming an emergent code: A0429, A0427, A0430, A0431, A0433, A0434, or A0225.

Unfortunately, there is no consensus among carriers on what should be typed into box 24C. Some want an 'X', others want a 'Y', still others want '1' or '2' or '3' indicating the code level of the ambulance response. As a result, you must manually edit box 24C when filing paper claims against these carriers.

Six-line addresses in box 32

If a carrier requires the origin and destination addresses in box 32 to be formatted on three text lines apiece (name + street + city/state/zip), rather than on two (name + street/city/state/zip), edit the carrier's insurance payor ID record and tick the ☑ Print the pickup and dropoff addresses in box 32 as six lines of text checkbox.

Other carrier requirements

In AngelTrack, each insurance carrier's Insurance Payor ID Edit page offers additional options for CMS-1500 markup, so check those to see if AngelTrack can automate your carrier's requirements.


Avoid Using Paper Claims Wherever Possible

Warning! Filing your claims on paper -- rather than electronically -- is a bad idea, because the CMS-1500 form is not designed for EMS claims: it is designed for ordinary doctor visits. Consequently, it omits several important pieces of ambulance information:

  1. Reason for transport (2300-CR109)
  2. Reason for transport code (A, B, C, D, or E in 2300-CR104)
  3. Ambulance certifications (01, 04, 05, 06, 07, 08, 09, and/or 12 in 2300-CRC03)
  4. Claim notes (2300-NTE02)
  5. Service line notes (2400-NTE02)
  6. Accident was caused by another person (AP in 2300-CLM11)

The aformentioned information is included in an electronic claim but not in a paper claim. Consequently, paper claims are more likely to be denied.


Filing an Electronic Secondary After Filing a Paper Primary

If the primary carrier demands paper claims, then they may send their EOBs likewise on paper. If they also fail to forward the claim to the secondary carrier, then you will have to do it yourself, by transitioning the adjudication data back to electronic format.

AngelTrack can do this with you. When you input the paper EOB using AngelTrack's Record a Payment Event page, click the link "Input the adjustments from a paper EOB, for use in filing an electronic secondary claim" to open the chart of service lines. Enter all of the CARC data from the paper EOB. AngelTrack will then have the data necessary for filing an electronic secondary.

After doing that, scroll down to "Next Steps" and send the call back to "Billing Office". It will reappear in the Insurance Filing Queue to be batched up for the secondary.


Manual Download of CMS-1500 Forms from AngelTrack

At any time, you can bypass all of AngelTrack's workflow UI, and manually download the CMS-1500 form for a specific dispatch or claim batch. You can do this regardless of the postprocess workflow and regardless of any claim status or batch status.

To download the filled-out CMS-1500 form for dispatch 12345, enter this URL into your web browser's address bar:

https://your_server_name.angeltrack.com/claim/pdf/12345

...and then AngelTrack will download the .PDF to you immediately.

Likewise, to download a combined .PDF containing filled-out CMS-1500 forms for all claims in batch 23456, enter this URL:

https://your_server_name.angeltrack.com/batch/pdf/23456

These URLs are accessible to anyone in the "Biller" role.



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