New RED HCFA forms, Possible MisAlignment

March, 2007

 

It has recently come to our attention that there are incorrectly formatted versions of the revised form being sold by print vendors, specifically the Government Printing Office (GPO). After reviewing the situation, the GPO has determined that the source files they received from the NUCC’s authorized forms designer were improperly formatted. This resulted in the sale of both printed forms and negatives which do not comply with the form specifications.

 

How to detect wrong format:

 

Old form	In lower right hand corner, you’ll see: Approved OMB-0938-0008 FORM CMS-1500 (12-90)”
New Form	Approved OMB-0938-0999 FORM CMS-1500 (08-05)
New form alignment	The best way to identify if your CMS-1500 (08-05) version forms are correct is by looking at the upper right hand corner of the form. On properly formatted claim forms, there will be approximately a ¼” gap between the tip of the red arrow above the vertically stacked word “CARRIER” and the top edge of the paper.   If the tip of the red arrow is touching or close to touching the top edge of the paper, then the form is not printed to specifications.

 

 

 

 

Given the circumstances, CMS has decided to extend the acceptance period of the Form CMS-1500 (12-90) version beyond the original April 1, 2007 deadline while this situation is resolved. Medicare contractors will be directed to continue to accept the Form CMS-1500 (12-90) until notified by CMS to cease. At present, we are targeting June 1, 2007 as that date. In addition, during the interim contractors will be directed to return, not manually key, any Form CMS-1500 (08-05) forms received which are not printed to specification. By returning the incorrectly formatted claim forms back to you, we are able to make you aware of the situation which will allow you to begin communications with your form supplier.