Preview CMS 1500 Form

Use the Preview CMS 1500 Form tool to confirm that your practice settings and information are accurate before submitting a bill.

Step 1. On the navigation bar, click ‘Settings’, then click the name of the Billing Provider.

This navigates directly to the selected Billing Provider.

Step 2. Click the ‘CMS 1500 Form’ button

Step 3. From each dropdown menu, select the ‘Rendering Provider,’ ‘Place of Service,’ and ‘Injury State’

The information you select populates the CMS 1500 form preview per the selected Injury State regulations.

Step 4. Click ‘Preview Form’

Clicking this button creates a sample claim form in PDF format and adds the file to your Downloads. Review the form to confirm your practice information is correct.

That’s that!