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Kareo Help Center

Configure Payer Paper Claim Settings

If you plan to submit claims in paper form, you can configure paper claim settings for an insurance company. This is a permission-based task; if you do not have access to configure settings, please contact your Kareo PM application administrator. See also the Kareo PM guides to CMS-1500 forms, and the FAQs about the new CMS-1500 form version 02/12.

To configure paper claim settings

  1. Click Settings > Insurance > Find Insurance Company.
  2. Once you find the insurance company, double-click to open the record.
  3. Click the Paper Claims tab. Select your settings. See below.
  4. Click Save or the Electronic Claims tab to complete electronic claims information.

Paper Claims Tab

Insurance Company - Paper Claims Callouts.jpg

a. Insured Format: Select one of the following:

  • Default - Leave at "Default" unless billing for Medicare.
  • Medicare style - This will prevent information from printing in Boxes 4 and 7, and will print NONE in Box 11.

b. CMS-1500 field 24g: Select “Units” (standard) or “Minutes” (typically only used for anesthesia related charges).
c. CMS-1500 field 32b: Some insurance companies require the facility ID associated with a service location to be included on the paper claim. This box is checked by default; the system will automatically pull the facility NPI from the service location record. Uncheck to block this action.
d. Primary Billing Form: The CMS-1500 format required by this insurance company as the primary payer on a claim.
e. Secondary Billing Form: The CMS-1500 format required by this insurance company as the secondary or tertiary payer on a claim.
Note: In most cases you can use the same form for both primary and secondary.  If you are not certain which form to use, contact the insurance company directly for clarification.
f. Institutional Claim Format Settings: There is currently only one format; leave at the default.