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Bill Instructions: CMS-1500 (HCFA)

Last update
June 17, 2019

In Colorado, healthcare providers use the CMS-1500 (HCFA) Form to file original workers' compensation medical bills.

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CMS-1500 (HCFA)

Applicable Services

Reporting Requirements

Forms & Attachments

Timely Filing

120 days from DOS

Filling out the Form

Instructions

CMS-1500 (HCFA) Services

The following table provides a link to the Colorado rules which require a provider to use the CMS-1500 (HCFA) for billing purposes.

Service

Rule

All Professional Services

Division of Workers’ Compensation 7 CCR 1101-3 Rules of Procedure; Rule 16 Utilization Standards

DME

Ambulance Services (Except for Dental)

CMS-1500 Required Billing Documentation

For a complete bill, Colorado requires the provider to submit the following supporting documentation with the CMS-1500 Form, when applicable.

 CMS-1500 Medical Bill

Required Supporting Documentation

Treatment

Copies of the examination, surgical, and/or treatment records.

For additional information on medical billing please refer to DaisyBill’s Colorado Billing Guide.

Timely Filing

Provider must submit medical bills within 120 days of the date of service.

Form

Timely Filing

Rules of Procedure

Rule

CMS-1500

120 days from Date of Service

Colorado Department of Labor and Employment  

7 CCR 1101-3 Rule 16 Utilization Standards

CMS-1500 (HCFA) Form Instructions

The state of Colorado requires providers to submit a complete CMS-1500 Form, but Colorado offers no further instructions.

To make workers’ comp easier, DaisyBill created this NUCC CMS-1500 Instructions Table listing the requirements of the National Uniform Claim Committee (NUCC), the entity which created and maintains the CMS-1500 form. This information is provided for educational purposes only and is not intended to represent state-specific requirements.

For additional information, review the complete NUCC Manual:
1500 Health Insurance Claim Form Reference Instruction Manual for Form Version 02/12

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