These SmartForms CMS-1500 PRO instructions will take you from a novice to an expert. If you have any difficulty, we provide free unlimited support to ensure your satisfaction. Contact details are below.

GETTING STARTED

This software has three sections; Patients, Claims and Processing.

  • PATIENTS: All patients with an established record will be listed in the Patient area.
  • CLAIMS: Each claim generated and saved will be found in the Claims and Processing sections. The Claim area is organized by Patient name, allowing user to see all claims for each patient. To generate subsequent claims for the same patient, you will return to this section.
  • PROCESSING: All saved Claims are in this section, organized by the claim status:

    1. To be submitted
    2. Waiting for Payment
    3. Paid. This section will allow you to submit and track claim payments.

Create a Template: The first operation to prepare your software for operation is to enter and save your provider information as a template. The template function allows you to enter common information that is required on each form. You may create multiple Templates. From the Top menu bar choose Template List. A template list box will appear. Choose Action/New from the menu bar, this will bring a CMS-1500 entry form on the screen. In the field titled Template Name, enter a Name for this template, i.e. Dr. John Smith. You may now enter your provider information. Some of the fields providers commonly complete are fields 25, 31, 32 and 33. To create a list of providers, double click on field 32 or 33 and a dialog box will appear that will allow you to complete and save the provider information to a list. Save all providers as required in these boxes. Scroll to the top of the form and click SAVE. Once a Template is created and saved, it will be available to use for claims. When a new claim is started you will be asked which template you would like to use. The software allows multiple templates; we recommend creating a template for each provider.

CREATING YOUR FIRST CLAIM

PATIENTS: From the Patients area choose Actions|New from the Patients menu bar. A dialog box will appear with two tabs; Patient Info and Insured’s. The Patient Info tab will collect information that correlates to Boxes two, three and five on the CMS-1500 claim form and the Insured’s tab correlates with Box 1, 1A, 4, 6, 7, 9, 11 and 11a. Complete both tabs with the details about the Patient. Click: Save; the program automatically names your record by Patient Name and record creation date. This patient will now appear in the patient list. Staying in the Patient List area, highlight the patient you wish to generate a CMS-1500. While the patient name is highlighted, move mouse to Claim section and choose Action|New; you will be asked which Template that you would like to use, choose the desired template.

CLAIMS: After you complete the steps above, you will see a claim form on your screen with the provider information and your patient information already inserted. Now follow the Form Completion steps to complete the remainder of the claim form.

NOTE: You have two choices for completing a CMS-1500 Claim Form; you can insert content to a claim form by tabbing through the fields on the form or you may enter the information to a list of fields. The program opens by default to the claim form for you to tab from field to field. If you wish to switch to the list of fields, click “Switch to Tab” on the top left menu.

FORM COMPLETION

The Payer information Dialog box can be opened by double clicking on the box. Enter the payer information and then Click: Save. Each Payer added to the list will be available to select on future claims. The payer information is now available for all patients. Add additional claim information. Diagnosis codes are to be entered for box 21 and are automatically saved to a list for use on future claims. After entering the diagnosis code in fields A thru J, clicking on the + sign at the right of the field will produce a dialog box allowing you to describe the code and save it to a list for future retrieval. Box 24 will allow you to enter information that is related to the procedure. After the procedure information has been entered the entire line A thru J can be saved by clicking on the + sign to open a dialog box allowing the procedure to be named and then saved to a list for future use. Boxes 25 thru 33 are pre-filled with information from the selected template.

The completed claim can now be saved; in the Claims box, go to Claim: SAVE. The system will Save this claim by the patient name and claim creation date. You will find the claim listed in the Claims box for the specific patient and in the Processing box indicating that it is ready for printing or electronic batching.

COMPLETING A CLAIM FOR AN EXISTING PATIENT

Go to the Patient Box and highlight an existing patient name. You will see a list of all previous claims for that patient in the Claims box. Editing an existing claim is the easiest and most accurate method of creating a new claim for an existing patient. To edit an existing claim you may highlight the claim you would like to edit in the Claims box and choose Action|Edit or double click on the desired claim. The form will appear ready for editing. Check and edit for current codes and dates. This will allow you to create and save a new claim with a few clicks. Once the new claim is prepared by editing the most recent claim for that patient you will go to the form’s Menu: Claim and select SAVE AS NEW. You have now completed a Claim for an Existing Patient and can find this claim in the Claims and Processing sections.

PRINTING AND ELECTRONIC BATCHING

If you are submitting forms manually or mailing your claims, you will print your claim forms. The SmartForms system offers two printing options: Print on Plain Paper or Print on Form. When printing on plain paper, the CMS-1500 form and claim information are printed in black ink. When using the Print on Form option, your claim information will be printed out in black ink on the approved red pre-printed forms. If you are submitting electronically, you will save a group of claims into a single file. That file will be uploaded for processing at your clearinghouse.

PRINTING CLAIMS

In the Processing area select the claims you want to print; Check the box to the left of the claim. Move mouse to the PRINT item on the menu bar and the two options will appear. Select PRINT Selected Claims or PRINT Selected Claims On Form. Note: You can check or uncheck all claims with the box in the header. Claims selected can all be printed out with one command. Once a claim is Printed, that claim is automatically moved to the Status: Waiting for Payment and filed in the Waiting for Payment list.

Printing Claims on Plain Paper: Follow instructions above and print out claims with one click.

Printing Claims on Approved Red-Pre-Printed Forms: Medicare and others require the approved red pre-Printed forms. Using the CMS-1500 PRO, your claims will print out on the approved forms. To be sure your claims will not be rejected, you must use the approved forms from a reputable form company. To be sure your claim information fits properly in each box, you will use a test file to print out on the claim forms. Load your printer with the approved forms. Go to Settings, choose Print on Form Alignment: Actions: Print. Look at the form after printing and see if the test data fits into the boxes on the form. If the content fits properly in the boxes, you are ready to print out claims on your pre-printed forms. If an adjustment is required, follow this process:

Look at the claim printed on the pre-printed form and use the x’s in Box 1 as a guide. Alignment can be adjusted in 4 directions; up and down or left and right. If the X’s fall above the box, the DOWN arrow key will move them to the correct position. If they fall below the box, the UP arrow key will correct their location. The Right arrow key will move the characters right and the Left arrow key will move the character left. Typically the entire page requires adjustment. You will use the arrow keys on your keyboard to make the adjustments. For each click of your arrow key, the character will move ¼ space; i.e. 4 clicks are equal to one character space.

To adjust the alignment:

  1. Click Actions: Move All
  2. Click your Arrow Keys in the direction required to move the characters to the desired location.
  3. After adjustments are complete, click SAVE.
  4. Now select Actions: Print again and determine if alignment is correct or further adjustment is required; if so, start again with Step 1.

Once Alignment is correct in Box 1, look at Box 25. Check the XX’s are aligned to ensure the bottom half of the form is correctly set up. If not aligned, choose: Actions: Move bottom. Use the arrow keys to move the characters to fit in Box 25 and adjust as needed, saving after each adjustment. Once the correct alignment is achieved and SAVED, this will be the default alignment for all print on form claims.

Restore Default Printer Settings: At any time you can start the alignment process over by clicking Restore Default Printer Settings. This will restore Printing to the Original Alignment.

ELECTRONIC SUBMISSION AND BATCHING CLAIMS

Your SmartForms CMS-1500PRO Program has built in functionality that will allow you to submit your claims through a clearinghouse to simplify claim processing and accelerate reimbursements. To easily process your claims you need the SmartForms CMS-1500PRO and an account with a clearinghouse.

Preparing your claims for submission is a two-step process. Step One is preparing the claim in the SmartForms program and creating a batch; Step two is uploading the batch to the Clearinghouse. The following instructions will help you create a batch. To create a batch file, select all the claims to be compiled and click Create Batch and all the selected files will be complied in a new file that you will save on your computer or network. In the dialogue box, you will see Open and Save; select SAVE and OK and a new dialogue box will open. Choose the location and name the file. The default name is Claim.txt. You may rename or use this name. Now you have created and saved a batch file that is waiting for the subsequent step of uploading to your clearinghouse. Your challenge in this step is saving the file in a location on your computer or network that you will easily be able to find at the next step. Once a claim is batched, it status changes and will now be filed automatically in the Waiting for Payment list.

The next step is to upload the batch to your clearinghouse for processing. You will leave your SmartForms program and go to your online clearinghouse page and login. Once logged in, follow the instructions, select the upload function and find the claim batch that you named and saved and submit (or upload) for payment.

GOOD LUCK!

You may call 866-681-1887 or email us at info@smartforms.com if you need help or if you would like to order over the phone.

Contact Info

  • SmartForms
  • 866-681-1887 or 772-220-9911
  • Palm City, Florida
  • Monday - Friday, 8:00 AM - 6:00 PM Eastern