PAYER RELATIONS
Specific Payer Items

Paper Billing and the CMS 1500 Form
 
May 31, 2007

For Empire Blue Cross:
We are currently accepting both forms and do not have a set cut off date for accepting the HCFA 1500 form.

Our current plan is to allow a migration period and continue accepting the old form until we receive 97% of the new forms. We are currently receiving approximately 50%. Any change in this plan will be communicated in our Provider Newsletter.

For Oxford and United Health Care (UHC):
Both Oxford and United will take either format. We will not reject or deny any claim that does not conform to the new data requirements of the new form for the foreseeable future.

For GHI
We have no plans to reject a claim based on claim form type being used, however, providers should be encouraged to use the new forms as they accommodate the NPI.

For Aetna
There is no policy defining an established end date to discontinue the intake of the prior HCFA 1500 (12/90) form nor the prior UB92 or 1450 form versions. Aetna will continue to accept and intake both prior forms when completed with all data elements necessary for claim processing.

For Health Net
In recognition of the implementation issues for the providers, Health Net expects to continue accepting the old form beyond July 1, 2007. 

For HIP
HIP will continue to accept the HCFA 1500 claim forms along with the new CMS 1500 claim forms in 2007. Presently, there is no date anticipated to discontinue use of the HCFA 1500 form.

When, or if, other plans get back to me, I will let you know. If you here from other plans on how they will be addressing this or related issues, please tell me.

Regina McNally, VP
Division of Socio-Medical Economics
Medical Society of the State of New York
420 Lakeville Road - PO Box 5404
Lake Success, NY 11042

516-488-6100, Ext. 332

Fax 516-352-4093