Harvard Pilgrim is now accepting the new Centers for Medicare and Medicaid Services (CMS) 1500 Claim Form (revision 02/12). CMS revised its CMS-1500 Claim Form to accommodate needs for reporting ICD-10 and to better align with changes in electronic professional claims. The updated form, CMS-1500 (rev. 02/12), replaces the CMS-1500 (rev. 08/05) form.
Harvard Pilgrim will follow CMS’ timeline for transitioning to the new CMS-1500 (rev. 02/12) claim form:
- January 6, 2014: Harvard Pilgrim begins receiving and processing paper claims submitted on the CMS-1500 Claim Form (rev. 02/12).
- January 6 through March 31, 2014: Dual use period during which Harvard Pilgrim continues to receive and process paper claims submitted on the old CMS-1500 Claim Form (rev. 08/05), as well as the new one (rev. 02/12).
- April 1, 2014: Harvard Pilgrim receives and processes paper claims for professional services submitted only on the revised CMS-1500 claim form (rev. 02/12). If Harvard Pilgrim receives claims submitted on any old version CMS claims forms (including rev. 08/05), these claims will be returned to the provider and will not be processed.
For more information, please see the paper claims section of the Provider Manual.