Adding Elements on the HCFA 1500 Form

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HCFA 1500 Boxes and Where Information is Pulled
DrChrono will pull data from a patient’s chart and your office settings to populate the CMS HCFA-1500 form. The following is a guide to identify which fields the data will be pulled from so updates can be made if necessary. Ess...
HCFA 1500 Box 23 - Print CLIA number on claim form
If you bill for laboratory services rendered to your patient, your CLIA number must be printed in box 23 of the HCFA-1500 claim form. Once you have your CLIA number listed in the settings on your account, it will automatically print in box 23 when ...
Video: Printing a HCFA 1500 form
Watch this video and see multiple ways to print an HCFA 1500 form. ...
My printed HCFA form is not aligned.
In DrChrono you may fill out HCFA-1500 forms by printing your claim information directly onto the blank HCFA form utilizing the HCFA-1500 (text) option. The option in DrChrono is only configured to work with the most recent HCFA-1500 versio...
Video: Aligning your HCFA 1500 form
The HCFA 1500 text form should be used if you have the pre-formatted red HCFA paper loaded into your printer. If you are printing on plain, white, 8.5" x 11" paper, you want to use the HCFA 1500 non-text option. It w...
HCFA 1500 Box 11 - How to enter 'NONE' to be displayed
Most insurances do not require box #11 (Insured's policy group or FECA number) to display the word "NONE". However, you may come across this scenario specifically with Medicare. To update this information, please follow the steps outlined below: ...
HCFA 1500 Box 12 - How does signature on file get added to a professional claim form?
The signature on file, box 12 on the HCFA-1500 form, is populated from the patient chart in two ways: manually or through signing a consent form. The signature on file can be found in the patient's chart by selecting the...
HCFA 1500 Boxes 14 & 15: Initial Visit and Onset Dates
DrChrono allows you to set an initial visit date for your patient so that you can have this automatically populate on your HCFA-1500 forms. To set the initial visit date please follow these instructions: 1. Navigate to the patient's chart ...
HCFA 1500 Box 17 - How do I print the referring/supervising provider's information
  There are 2 different ways to print the referring provider's information in box 17 on the HCFA 1500 form.  Persistent - You can enter into the patient's demographics so that it will appear on all of the patient's future appointment...
HCFA 1500 Box 19 - How Do I Add a Billing Note
Occasionally, you might need to add extra information to Box 19 on the HCFA claim form that will be transmitted to the payer with the claim. DrChrono makes it easy to add whatever you need. Once inside the appointment ( Billing > Live C...
HCFA 1500 Box 21 - Procedure Code Qualifier
On both professional and institutional claims, the entity must disclose whether ICD-9 or ICD-10 codes are being utilized. Since October 1, 2015 claims have been required to use ICD-10 coding. DrChrono will automatically print the procedure code...
HCFA 1500 Box 24J - How Do I Enter an Individual or Group Provider Identifier?
Sometimes a payer will require a separate identifier on the claim along with the billing/rendering NPI. DrChrono makes it easy to add this information, by payer, so that it will be on each claim, helping to ensure that your claim is accepted for pr...
HCFA 1500 Box 31 - Print License On the claim form
If the payer requires, you can print your state license number on the HCFA form in box #31 and the charge line. To set it up, follow the steps below. 1. Navigate to Billing > Insurance Set Up 2. Click on the Edit (Pencil...
HCFA 1500 Box 32 - Setting the Service Location
If you are seeing patients outside of your normal office location, the service location address must be disclosed in box 32 of the HCFA 1500 form, along with the POS code that coordinates with the service location. This article will explai...
HCFA 1500 Box 33 - How Do I Use an Alternative Pay to Address
If you want to add an alternative pay-to address or lockbox (P.O. Box) address in box 33 on the HCFA 1500 Form, follow the steps outlined below: 1. Hover your cursor on the Account tab and select Offices . 2. Click on the Edit b...
HCFA 1500 Box 33b - How Do I Enter an Individual or Group Provider Identifier?
Sometimes a payer will require a separate identifier on the claim along with the billing/rendering NPI and Tax ID. DrChrono makes it easy to add this information, by payer, so that it will be on each claim, helping to ensure that your claim is a...