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.


Nobody is Allowed to Refuse Electronic Claims

Federal law 42 USC § 1320d-2 and federal regulation 45 CFR Part 162 require all HIPAA-covered health plans to accept electronic transactions, and to do so in the standard format (X12.837) provided by AngelTrack. That's the law and it is not in dispute.

If an insurer is demanding paper claims, perhaps they just need to be reminded of their legal obligations as an insurer.

If they still refuse, then AngelTrack will automatically fill out your paper claims for you.

In that event, AngelTrack support will help you file a formal complaint with the attorney general's office in the carrier's home state, because it's neither moral nor legal for the carrier to burden your billing office with the hassle of filing paper claims.


Blank CMS-1500 Paper Forms are Required

You must purchase blank CMS-1500 forms suitable for your printer; do not attempt to print your own forms on blank paper, because the scanning machines require an exact print geometry and an exact tone of red ink. If you printed your own, 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 non-compliant .PDF readers, along with a few buggy printer drivers, fail to omit the red background when printing the 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


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.

The batch can also re-download the claim forms to you again later, should you need to reprint them. In the Insurance Transmission Queue, simply click the "1500" download link 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 bundle up all the .PDFs into a .ZIP 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.


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.

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 forever, 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.


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. You should not use paper claims unless there is absolutely no alternative.


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.angeltracksoftware.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.angeltracksoftware.com/batch/pdf/23456

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



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