Common questions: Completing the CMS 1500 form on Healthie

Our goal at Healthie is to make it easy for providers to create and submit insurance claims to streamline billing. Here are some answers to commonly asked questions re: filling out the CMS 1500 form. 

What insurance companies are compatible with Healthie's Billing Software?

Healthie's CMS 1500 technology is compatible with all insurance companies - we generate industry-standard forms and integrate directly with free online clearinghouses like Office Ally. As a result, providers can submit claims to any insurance company using Healthie. 

Who is the policy holder?

The Name of the Policy Holder is the "Primary Holder" of the insurance account. Oftentimes this is the name of the patient that you are working with. Sometimes, however, it is a relative - in this instance, put down the name of the primary holder, and the relationship between the primary holder and the patient. 

What are CPT and ICD-10 codes? 

CPT codes are the shortened form of Current Procedural Technology. CPT codes show what treatment you provided for your client. They include every type of service or procedure (tests, evaluations, etc.). The CPT codes that you include on your Superbill are the services your client could be reimbursed for. Common codes for nutritional care are 97802, 97803, and 97804. 

ICD codes (or sometimes ICD-10) is shorthand for International Statistical Classification of Disease and Related Health Problems 10th Revision. ICD-10 is a clinical cataloguing system that assists in making a diagnosis. ICD-10 is the latest version of this code. (ICD-9 will likely be rejected because it is outdated). ICD-10 has been digitalized so that it now more accurately reflects our understanding of health problems today and includes a greater variety of classifications.  ICD codes, simply put, represent the symptoms that your client is seeking to treat.

Here is a link to all ICD-10 codes (note - many are already pre-loaded into the Healthie system).

I need to add a CPT or ICD-10 code into Healthie - how do I do this? 

If you need to include a CPT or ICD-10 code that is not pre-loaded into the Healthie system, message our live chat or contact us: hello@gethealthie.com and we'd be happy to add this for you. 

What is the ICD Ind field? 

The ICD Ind field denotes whether a diagnosis code is from the ICD-10 or ICD-9 set, and does not reflect the actual diagnosis entered. It may appear in a generated PDF as 9 or 0.

Do I need the address of the Policy?

This is not a required field in Healthie. Each Policy name has a designated code associated with it that auto-populates the address for you in the CMS-1500

What are diagnostic pointers?

Diagnostic Pointers (Box 24e on the CMS 1500 form) are used to indicate the line letter from the diagnosis code, that relates to the reason the service(s) was performed. You can include up to 4 diagnostic pointers on each line. The first  pointer designates the primary diagnosis for the service line. Remaining diagnosis pointers indicate declining level of importance to service line.

How do I submit a document (e.g., chart note, physician referral) to accompany a claim? 

Please download your document as a PDF and submit this directly in your Clearinghouse

How can I create a CMS 1500 form for another provider in my organization?

While completing your CMS 1500 form, Scroll down to "Rendering Provider" and select the Rendering provider within your organization.