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Bulletin 0003: New CMS 1500 Form Version 02/12

This bulletin applies to all users of CollaborateMD and is specific to the new Centers for Medicare and Medicaid Services (CMS) 1500 Form Version 02/12.

CMS 1500 Form Version 02/12 will replace the current CMS 1500 Form Version 08/05, effective with claims received on and after April 1, 2014:

  • Medicare began accepting claims on the revised CMS 1500 Form Version 02/12, on January 6, 2014
  • Medicare will only accept claims on the old CMS 1500 Form Version 08/05, through March 31, 2014
  • On April 1, 2014, Medicare will accept paper claims on only the revised CMS 1500 Form Version 02/12; and 
  • On and after April 1, 2014, Medicare will no longer accept claims on the old CMS 1500 Form Version 08/05
  • Please ensure your billing staff members are aware of these instructions for the revised CMS 1500 Form Version 02/12



What CMS 1500 Forms are supported by CollaborateMD?
  • Version 8.5 will not support the revised CMS 1500 Form Version 02/12 needed for paper claims.  Users will need to upgrade to Version 9.1 if they are required to send paper claims.
  • Version 9.1 (and future releases will) fully support the revised CMS 1500 Form Version 02/12



How do I upgrade from 8.5 to Version 9.1 to use the new CMS 1500 Form Version 02/12?


Special Notes
  • Although the revised CMS 1500 Form Version 02/12 support the functionality for accepting ICD-10 codes, do not submit ICD-10 codes on claims for dates of service prior to October 1, 2014.



How do I ensure I am using the new CMS 1500 Form Version 02/12 within CollaborateMD for all my Payers?
  • Please reference the step by step instructions listed below to change all your payers from the old CMD Form Version 08/05 to the revised CMD Form Version 02/.12 within Version 9.1.


1.  Run the CollaborateMD application.
2.  Click "Payer" within the menu bar.
3.  Ensure you are within the "Payer" tab (within the Payer Section).
4.  Click "CMS Form Version" or press keys "Alt+M" from your keyboard to display the "Payer CMS Form Version" dialogue window (Steps 5 - 7).
5.  Select "1500 (02-12)" for your Professional Claims.
6.  Click "Apply Changes" to set ALL Payers to use the new CMS 1500 Claim Form Version 02/12.
7.  Click "Close".



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