![]() When billing CMS-1500, Health Net only accepts standard claim forms printed in Flint OCR Red, J6983 (or exact match) ink. If non-compliant, paper claims follow the same editing logic as electronic claims and will be rejected with a letter sent to the provider indicating the reason for rejection. ![]() The form must be completed in accordance with the guidelines in the National Uniform Claim Committee (NUCC) 1500 Claim Form Reference Instruction Manual Version 5.0 7/17. Providers billing for professional services, and medical suppliers, must complete the CMS-1500 (version 02/12) form. Requirements for paper forms are described below. Refer to electronic claims submission for more information.įor providers unable to send claims electronically, paper claims are accepted if on the proper type of form. Health Net prefers that all claims be submitted electronically. You can choose to sync these tasks as all day events in Google Calendar, or you can opt to only sync tasks with a due date and time.Health Net requires that Enhanced Care Management/Community Service (ECM/CS) providers submit fee-for-service professional claims on the paper CMS-1500 claim form, EDI 837 professional, or Health Net invoice form.
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