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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

January 2014

New CMS 1500 Claim Form Now Accepted

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.

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Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,

Kristin Edmonston,
Production Coordinator