Claim Forms: Client Information - Box 2, 3, 4, 5
The client personal information will be populated in the CMS 1500 claim. Once the first claim form is completed for a client, this information will autofill for subsequent claims, making quick work of billing processes.
Client following client information should be completed:
- Client Legal Name
- Client date of birth (required for claim forms, if collected in your intake paperwork then this information will auto-fill)
- SSN (social security number may not be required for claim submission, please check with the individual insurance payer)
- Gender (unfortunately, this field is required by insurance payers, and a selection of male or female must be selected. Learn more about documenting gender & gender identity in Healthie here).
- Client address
Information from the Client Information section of Healthie will populate Boxes 2, 3, 4, and 5 on the CMS 1500 claim form.
Client Legal Name
To avoid claim denials, please ensure that your client's name as displayed on their insurance card matches your client name.
By default, the First Name, Last Name that is listed in your client's profile is the name that will match to Box 2 on the claim form. If your client has a a preferred name that differs from the name on their insurance card, please add a Legal Name to the client's profile.
Client Profile > Actions > Personal Information > Legal Name
The Legal Name will populate in the claim form Box 2, and the client's Preferred Name will populate elsewhere throughout the platform. You can learn more about client legal and preferred names here.
Client Gender
Unfortunately, this field is required by insurance payers, and a selection of male or female must be selected.
However, we understand how important it is to be inclusive and respectful of your client's preferred gender identity and pronouns. Learn more about documenting gender & gender identity in Healthie here.