Insurance Claims After an Accident: The Basics, insurance claims process.#Insurance #claims #process


Insurance Claims After an Accident: The Basics

One of the first things you should do after being injured in an accident is to file an insurance claim with your insurance provider or the insurer of the person or business responsible. An insurance claim will allow you to receive compensation for any medical expenses, lost wages, or pain and suffering that result from the accident. Below, you’ll find explanations of the insurance claims process, how insurance companies calculate the value of a claim, and the differences between first party and third party claims.

First Party Claims vs. Third Party Claims

There are two types of insurance claims: first party claims and third party claims. While a first party claim is one you file with your own insurance company, a third party claim is one you file with the insurance provider of another person or business. Most insurance holders have coverage for third parties who are injured as a result of their actions.

The type of claim you file will depend on who was at fault in the accident, the type of accident that occurred, and the extent of your insurance coverage. For example, if you caused an accident while driving in your car, you should probably file a first party claim with your auto insurance provider. On the other hand, if you were hit by a car while crossing the street or were involved in an accident while a passenger in a car, you should file a third party claim with the driver’s auto insurance provider. Alternatively, if you were injured while shopping in a store or eating at a restaurant, you can file a third party claim with the business’ insurance company.

The Insurance Claims Process

Whether you were injured in an automobile accident, at a home or building, or while visiting a business, you typically must report the incident to the insurance company within 24 hours of the incident. If you weren’t at fault for the accident, you should contact the insurance provider of the business, building owner, or at-fault driver. You’ll probably be required to provide information about the cause of the accident and the extent of your injuries.

The insurance company will then open an investigation of your claim. You may be asked to provide photos of the accident scene, the names of any witnesses, or a more detailed account of the incident. In addition, you will probably have to submit to an independent medical examination by a doctor of the insurer’s choice. If the injury was caused by a building condition, the claims adjuster may make an inspection of the property.

After calculating the value of your claim, the insurance company will then issue a settlement check. If your claim is denied or if you believe the amount of the settlement is inadequate, you can appeal to the insurance company. An appeal may require you to submit to additional examinations or provide further information and evidence about the accident.

Denial of Claims and the Appeals Process

There are a number of reasons why your claim may be denied. For example, you may have waited too long to file your claim or failed to submit to an independent medical examination. Alternatively, the type of accident you were involved in may not be covered under your insurance plan.

Whatever the case may be, you’ll receive notification from the insurance company if your claim is denied. It is then up to you to appeal the denial of claim. Appeals procedures can differ from company to company, so you should take a look at the policy in question to learn about the appropriate next steps. If you have questions about the appeals process or if your appeal is denied, it’s probably in your best interests to consult with an insurance attorney.

Calculating the Value of Insurance Claims

While medical expenses and lost wages are usually pretty cut and dried, it’s difficult to place a dollar amount on the pain and suffering a person experiences after being injured. Insurance companies have developed damages formulas to calculate how much to pay the injured for these types of non-monetary losses.

The insurance claims analyst first adds up all of your medical expenses. If the injuries aren’t too serious, this total is typically multiplied by 1.5 or 2 to determine the amount of your special damages. However, if the injuries are severe, the total may be multiplied by 5, or even 10 if the injuries are extremely debilitating. Once the special damages amount is determined, the analyst adds your lost wages to determine the amount of your settlement. You can then often negotiate with the insurance company to obtain a higher settlement.

Have Your Claim Evaluated Free of Charge

If you’re wondering why your insurance claim was denied or you believe the amount of your settlement is inadequate, a great first step is to have an attorney evaluate your claim. Fortunately, you can do so free of charge by contacting an experienced accident attorney for a free claim evaluation. An attorney will be able to answer any questions you may have about your claim and advise you about your options moving forward.


Car Accident Basics, accidents claims.#Accidents #claims


Car Accident Basics

Automobile accidents give rise to the majority of personal injury claims in the U.S. This isn’t surprising, given that there were 5,615,000 police reported car crashes in 2012, according to the National Highway Traffic Safety Administration (NHTSA).

Motor Vehicle Accidents and the Law

Legal claims arising from motor vehicle accidents are typically governed by the law of negligence. Generally, people who operate automobiles must exercise reasonable care under the circumstances. A failure to use reasonable care is considered negligence. A person who negligently operates a vehicle may be required to pay for any damages, either to a person or property, caused by his or her negligence. The injured party, known as the plaintiff, is required to prove that the defendant was negligent, that the negligence was a proximate cause of the accident, and that the accident caused the plaintiff’s injuries.

Negligence and Motor Vehicle Accidents

As with other types of accidents, figuring out who is at fault in a traffic accident is a matter of deciding who was negligent. In many cases, your instincts will tell you that a driver, cyclist or pedestrian acted carelessly, but not what rule or rules that person violated. An attorney will look to a number of sources to help you determine who was at fault for your accident, such as police reports, state traffic laws, and witnesses.

Courts look to a number of factors in determining whether a driver was negligent. Some of these factors include, but aren’t limited to, the following:

  • Disobeying traffic signs or signals
  • Failing to signal while turning
  • Driving above or below the posted speed limit
  • Disregarding weather or traffic conditions
  • Driving under the influence of drugs or alcohol

Other Common Causes of Automobile Accidents

A driver may be liable for an accident due to his or her intentional or reckless conduct. A driver who is reckless is one who drives unsafely, with clear disregard for the probability that such driving may cause an accident. The NHTSA defines aggressive driving as a progression of unlawful driving actions such as:

  • Speeding above the posted limit or driving too fast for the current conditions
  • Improper or excessive lane changing, including failure to signal intent and failure to check that the lane change can be made safely
  • Improper passing, including failure to signal intent and use of the shoulder, median, or an emergency lane to pass

On average, every 51 minutes, someone in the U.S. dies in an alcohol-related crash. Last year alone, over one million people were injured in alcohol-related traffic crashes. In a lawsuit arising from a drunk driving accident, in addition to the intoxicated driver’s liability for the injuries he or she caused, a bar or social host may be liable for damages if they served an obviously intoxicated guest, who then drove and caused an accident. The fact that the person who served the intoxicated driver alcohol may be held liable doesn’t relieve the intoxicated driver of liability, however. See the Dram Shop Laws article for more information about third party liability for drunk driving accidents.

Because attorneys are aware of the many laws governing legal responsibility, an attorney can help you identify who might be held responsible for your injuries, including people or businesses you might not have considered.

Accidents Not Caused by the Drivers Involved

In certain cases, accidents are caused by factors unrelated to the conduct of any particular driver. For example, an automobile accident may occur due to a defect in someone’s automobile. In such a case, an automobile manufacturer or supplier may be responsible for injuries caused by a defect in the automobile under the law of product liability. A product liability suit is a lawsuit brought against the seller of a product for selling a defective product that caused physical injury to a consumer or user. If a manufacturer of a product creates a defective product – either in designing, manufacturing, or labeling the product – the manufacturer is liable for any injuries the product causes, regardless of whether the manufacturer was negligent.

Other factors, such as poorly maintained roads and malfunctioning traffic control signals can contribute to cause an accident as well. Improper design, maintenance, construction, signage, lighting, or other highway defects, including poorly placed trees and utility poles, can also cause serious accidents. In cases such as this, government entities may be potential defendants. Special rules apply to claims and lawsuits brought against governmental bodies, however, and proper legal advice is critical to preserving and winning such claims.

Learn More About Your Claim With a Free Consultation

If you or a loved one has suffered a car accident injury, some important questions need to be answered. Reviewing your claim with an attorney can help you identify who, if anyone, was negligent and if that negligence caused your injury. That’s why a good first step is to contact an auto accident attorney for a free claim evaluation. An attorney can evaluate the merits of your case and help you decide on the next logical step.


Mortgage claims, mortgage claims.#Mortgage #claims


N.J. mortgage lender to pay $74M to settle violation claims

MOUNT LAUREL — Authorities say New Jersey-based PHH Corp. and two of its subsidiaries have agreed to pay $74 million to settle claims that they violated standards for underwriting government-backed mortgages.

“This settlement requires PHH to pay back to the taxpayers of the United States millions of dollars in loans that never should have been made,” Acting U.S. Attorney William E. Fitzpatrick for the District of New Jersey said. “By failing to ensure the creditworthiness of borrowers and otherwise failing to make sure the loans met HUD underwriting requirements, loans were insured by FHA that should not have been.”

The settlement announced Tuesday resolve allegations that PHH Corp. and subsidiaries PHH Mortgage Corp. and PHH Home Loans failed to comply with certain FHA, VA, Fannie Mae and Freddie Mac origination, underwriting and quality control requirements, the federal government says.

“Government mortgage programs designed to assist homeowners — including programs offered by the FHA, VA, Fannie Mae and Freddie Mac — depend on lenders to approve only eligible loans,” said Acting Assistant Attorney General Chad A. Readler, head of the Justice Department’s Civil Division.

The settlement with the government includes $65 million for alleged violations involving loans insured by the Federal Housing Administration, and nearly $9.5 million for loans guaranteed by the Department of Veterans Affairs.

About $9 million will go to a whistleblower who formerly worked for PHH, Mary Bozzelli, who filed a suit under the False Claims Act against PHH, according to authorities, and whose action prompted part of the probe against PHH.

“It is great to see PHH finally held accountable for its actions,” said Bozzelli in a statement issued through her attorneys, Nelson Thomas, Michael Lingle, and Jonathan Ferris of Thomas Solomon LLP in Rochester, N.Y. “Mortgage fraud is hardly victimless. Not only did PHH defraud taxpayers, but instead of helping deserving borrowers obtain home loans through the government loan programs, I witnessed firsthand the ways in which PHH abused the programs to line its own pockets.”

The settlements came as the result of investigations by numerous government agencies and federal authorities.

“We have agreed to resolve these matters, which cover certain legacy origination and underwriting activities, without admitting liability, in order to avoid the distraction and expense of potential litigation,” PHH said in a statement Tuesday. “While we cooperated fully in these investigations since receiving subpoenas in 2013, we concluded that settling these matters is in the best interest of PHH and its constituents. Adhering to high legal, regulatory and ethical standards is at the core of how we conduct business, and we remain committed to serving our customers and all of our stakeholders consistent with that principle.”

The government says it sustained “substantial losses” because of PHH’s alleged actions.


Reclaim Your Mis-sold PPI Today, PPI Claims Scotland, mortgage claims.#Mortgage #claims


Were you mis-sold Payment Protection Insurance – PPI Claims Scotland can help

Mortgage claims

Have you taken out a loan, mortgage or credit card in the last 10 years?

Did you know that creditors can no longer sell Payment Protection Insurance (PPI) as part of a debt?

PPI Claims Scotland will challenge the creditor on your behalf and help you claim back compensation now. We work hard to make sure the claim is thoroughly investigated and the money comes back to your pocket, in addition we operate on a ‘no win – no fee’ basis.

Hear What Our Customer Have to Say

“We had heard all about PPI being mis-sold and a few of our friends had got some money back. We registered on the website then were contacted to confirm a few details. We signed the letters they sent us and a few weeks later we started getting letters and offers from our banks. So far we have had over £16,000 with some still outstanding. We are so happy we registered. Now we are getting our house finished and planning a big holiday for next summer.” -C S W, from Kirkintilloch “I didn’t think I would get any money back from a loan I had taken out in 2005 but PPI Claims Scotland did all the work for me and I got back £3700. I couldn’t be more happy as I thought I needed PPI along with my loan and I didn’t.” – Jane McPherson, Dundee

We have successfully helped reclaim over £1,000,000 of PPI on behalf of our customers.

Mortgage claims

Why Use PPI Claims Scotland

We offer a NO WIN NO FEE guarantee and will not charge you a single penny for making a PPI claim on your behalf unless your claim is successful.

Mortgage claims

PPI Success Stories

We have helped 1000’s of people reclaim PPI. You don’t even need the paperwork to get started. Read about our success stories.

Mortgage claims

PPI FAQs

How Do I Know If I’ve Taken Out PPI in the Past? How long with it take? We answer the frequently asked questions to make reclaiming easy.

Mortgage claims

Start Your PPI Claim

With the government PPI deadline looming, there is no time to waste.

What Are You Waiting For?

Are you ready to get started?

What is PPI?

Mortgage claims

Payment Protection Insurance (PPI) was designed to ensure you could keep up your monthly repayments on debts like loans, credit cards or mortgages if you were unable to work due to an accident, sickness or unemployment (redundancy). It’s also known as Repayment Protection Insurance (RPI), Accident, Sickness and Unemployment Cover (ASU) and by many other names.

Most people were offered a PPI policy when they took out the money loan, credit card, mortgage, store cards or finance for a car. This practice changed in April 2006 so that most firms could no longer sell you PPI as part of the debt. When you took out a loan or credit you were under no obligation to insure the repayments in the event that you were unable to keep paying. This means that PPI was not compulsory a fact which many advisers and sales agents did not make you aware of.

How does PPI protect my Payments?

The benefits payable from PPI vary between each lender and insurance company but generally they pay your monthly commitments – loan or mortgage – for a defined period, normally up to 12 months.

Store cards and credit cards varied in that they would normally pay a percentage of your outstanding debt when you made the claim each month for up to 12 months. In both cases when your period of cover ran out you would have to continue to make the repayments even although you may not have returned to work.

Many PPI policies also included some life cover element, which in most cases, but not all, repaid the full outstanding balance when you died.

What Should I Have Known Before I Bought PPI?

There were dozens of different PPI policies sold and these varied in many ways including;


The Mortgage Lender Implode-O-Meter – tracking the housing finance breakdown, related to Alt-A and subprime


Housing Economic Crisis News Picks

  • China Makes Historic Move to Open Market for Financial Firms – [2017-11-10]
  • Ringleaders Of A $20 Million Florida Mortgage Fraud Scheme Convicted – [2017-11-10]
  • Irish Border Throws Unexpected Hurdle Into Brexit Talks – [2017-11-10]
  • White Plains CPA Sentenced To 22 Months In The Big House – [2017-11-10]
  • Suffolk County Attorney Indicted For Money Laundering – [2017-11-10]
  • Madoff victims set to receive $772 million payout – [2017-11-09]
  • Equifax profit falls as hacking costs take toll – [2017-11-09]
  • Macy’s Gains On Cost-Cuts As Peers Ail – [2017-11-09]
  • Foreclosed $51 Million “Billionaire’s Row” Penthouse Sells At A 30% Discount – [2017-11-09]
  • Wall St. retreats on worries over delays in tax-cut plan – [2017-11-09]

Latest Posts from the ML Forum!

Go to the forum!

Imploded* Lenders™

About The Implode-o-Meter

ML-Implode.com was created in late 2006 to raise the alarm about the then-burgeoning implosion of the historically-epic housing and economic bubble. Started as a modest web page created by founder Aaron Krowne, this objective was achieved by, uniquely, tracking the in-progress implosion of independent mortgage lending companies then being ignored by a mainstream media in denial of even the existence of the housing bubble. At that time, you were more likely to hear a partyline of “housing always goes up” and juvenile jeers of “bubbles are for bathtubs” from TV’s talking heads, than of even slight concern about a clearly-overextended, already-frozen housing market.

Operated as a broadly-open community forum, ML-Implode quickly took the lead in news about the mortgage implosion and subprime crisis, as industry professionals flocked to the site to share and find out the latest. The site even became, in part, a whistleblower platform, fighting (and winning) half a dozen lawsuits to defend the right of its contributors to post about corruption and malfeasance in financial companies, and be able to do so confidentially.

Despite its initial incarnation being rendered insolvent by these frivolous legal attacks, ML-Implode continues today in a stripped-down, lean-and-mean embodiment, remaining dedicated to tracking the fallout of the 2007-2008 credit crisis. This mission includes keeping tabs on recession/depressionary conditions, the policy response to the economic downturn and continued financial instability, the Fed and other global central bank interventions (including “ZIRP” and quantitative easing), actions and reforms of the monetary authorities, market manipulation (official and private sector), all global geopolitical conflict with economic roots, the evolution of the banking and monetary system (including dollar-alternative “reserve currencies”, gold, silver, and bitcoin and other “virtual currencies”), the effect of the economic turmoil on society, basic themes of economic fairness and justice, and much more.

We continue to doggedly watch all of these interconnected topic areas, daily picking the most important stories and commentaries, and bringing them together in a convenient and comprehensible form on this site. If you share our concerns, utilize one of the icons at the top of this page to “follow” us by twitter, RSS, email, and more.

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Box 17 – 19 – Reserved for local use – cms 1500, CMS 1500 claim


CMS 1500 claim form and UB 04 form- Instruction and Guide

Instructions and guideline for CMS 1500 claim form and UB 04 form. Tips and updates. Detailed review of all the fields and box in CMS 1500 claim form and UB 04 form and ADA form. HCFA 1500 and UB 92 form instruction.

Pages

Hcfa claim forms

Hcfa claim forms

Hcfa claim forms

Tuesday, November 30, 2010

Box 17 – 19 – Reserved for local use – cms 1500

0B = License Number

1D = 13-digit Provider ID number (Legacy

In the second portion, enter the license number of the referring or prescribing practitioner named in Block 17 (e.g., MD123456X). If the practitioner’s license number was issued after June 29, 2001, enter the number in the new format (e.g., MD123456).

If an out-of-state provider orders the service, enter the two-letter State abbreviation, followed by six

9 s, and an X. For example, a prescribing practitioner from New Jersey would be entered as NJ999999X.

Enter up to four, 4-character alphanumeric attachment type codes. When entering more than one attachment type code, separate the codes with a comma (,).

Hcfa claim forms

1 comment:

Hcfa claim forms

Find blank and fillable W-9 and 1500 Claim forms at PDFfiller.

You can fill the text fields, add a variety of checkmarks, digitally sign the form and even add pictures. After your pdf form is completed, it can be printed, emailed, faxed or saved on your computer. You can even send fillable pdf forms to your customers, employees, vendors and partners.


Hcfa claim forms, hcfa claim forms.#Hcfa #claim #forms


hcfa claim forms

CMS-1500 Or HCFA Claim Forms

Hcfa claim forms

CMS Form 1500 or formerly called HCFA Form 1500 is the standard insurance form used to bill Medicare Part B and other insurance carrier professional claims. There are several common reasons why paper claims get rejected. This article will help you with the most obvious ones. If your medical billing software is working correctly and you are using a HIPAA compliant version, the problem is of the most common variety. human error.

Take a look at an example of the new CMS-1500 02/12 claim form.

What are the changes? The biggest change is Box 21, the diagnosis box. The field has space for 12 codes and the diagnosis code pointers are now identified by letters A-L rather than numbers 1-4.

This article is not intended to tell you how to bill, but rather, to point out the most common reasons for HCFA rejections. (By the way, CMS 1500 is the correct and current form name. I use the term HCFA out of habit). Generally, commercial insurance carriers are more forgiving of errors on paper claims than Medicare and other government claims. Medicare requires that you dot every “i” and cross every “t”. Also, their rules are different so I have listed them separately. Please note that some of the errors mentioned below may never cause you a problem, but the point is, don’t give an insurance company any excuse to reject your claim.

General HCFA Rules

Be sure your forms are lined up properly and all data is in the correct boxes. Many carriers scan their claims and truncated data will cause claims to reject.

Box 12 – Enter the patient name or the words “Signature on File” in this field. This authorizes release of medical information and payment of government claims if assignment has been accepted in Box 27.

Box 13 – Enter the policyholder name or the words “Signature on File” in this field. This authorizes release of payment to the supplier of services indicated in Box 33. Please note that certain carriers will override this field and only pay the policyholder in the event that the provider is not contracted with the carrier.

Box 17 and 17b – In some instances, the referring provider name and NPI are required. No other pins or IDs should appear in Box 17a.

Box 24j – Enter the NPI of the rendering provider who performed the service. The NPI should appear on the bottom portion of Box 24j. No other pin or ID should appear in this field.

Box 25 – Enter the tax ID of the billing provider and indicate whether the ID is a social security number or EIN (Employer Identification Number).

Box 32 – If the place of service in Box 24b is not the office or the patient’s home, enter the name, address, and NPI where the service was provided.

Medicare Primary HCFA Rules

Box 4 – Leave blank.

Box 7 – Leave blank.

Box 11 – Enter the word NONE.

Box 11a through 11d – Leave blank.

Box 24e – You may enter 4 diagnoses in Box 21, however, only one diagnosis code pointer should appear in this field. It can be a 1, 2, 3, or 4.

Box 27 – Check the box yes or no to accept assignment.

Box 32 – Always enter the name, address, and NPI where the service was provided.

Billing Provider vs. Attending Provider

The following examples demonstrate how to set up your claims in different billing scenarios.

Example #1 Dr. A is a solo practitioner who is not incorporated. His NPI is entered in Box 24j and Box 33. His social security number is entered in Box 25 and checked as a type SSN.

Example #2 Dr. A is a solo provider who’s practice is incorporated. Dr. A’s NPI is entered in Box 24j. The “group” or corporate NPI is entered appear in Box 33. The corporate EIN is entered in Box 25 and checked as a type EIN.

Example #3 Dr. A’s practice is incorporated. Dr B. works for him. A claim for Dr. B will look as follows: Dr. B’s NPI will be enter in Box 24j. Dr. A’s practice name, billing address, and “group” NPI are entered in Box 33. The corporate EIN is entered in Box 25 and checked as a type EIN.

You’ll never avoid all paper claim rejections, but this information should help you avoid the most common HCFA rejections. If you are a Medisoft user and need help with setting up your paper claims properly, please visit our Medisoft Training page.

В© Copyright 2008 Medical-billing-guide.com

No reproduction permitted without permission.

Hcfa claim forms


Understanding the insurance claims payment process, III, insurance claims process.#Insurance #claims #process


Understanding the insurance claims payment process

Homeowners + Renters Insurance

After a disaster, you want to get back to normal as soon as possible, and your insurance company wants that too! You may get multiple checks from your insurer as you make temporary repairs, permanent repairs and replace damaged belongings. Here’s what you need to know about claims payments.

In most instances, an adjuster will inspect the damage to your home and offer you a certain sum of money for repairs, based on the terms and limits of your homeowners policy. The first check you get from your insurance company is often an advance against the total settlement amount, not the final payment.

If you’re offered an on-the-spot settlement, you can accept the check right away. Later, if you find other damage, you can reopen the claim and file for an additional amount. Most policies require claims to be filed within one year from the date of disaster; check with your state insurance department for the laws that apply to your area.

When both the structure of your home and your personal belongings are damaged, you generally receive two separate checks from your insurance company, one for each category of damage. If your home is uninhabitable, you’ll also receive a check for the additional living expenses (ALE) you incur if you can’t live in your home while it is being repaired. If you have flood insurance and experienced flood damage, that means a separate check as well.

If you have a mortgage on your house, the check for repairs will generally be made out to both you and the mortgage lender. As a condition of granting a mortgage, lenders usually require that they are named in the homeowners policy and that they are a party to any insurance payments related to the structure. Similarly, if you live in a coop or condominium, your management company may have required that the building’s financial entity be named as a co-insured.

This is so the lender (and/or, in the case of a coop or condo, the overall building), who has a financial interest in your property, can ensure that the necessary repairs are made.

When a financial backer is a co-insured, they will have to endorse the claims payment check before you can cash it.

Depending on the circumstances, lenders may also put the money in an escrow account and pay for the repairs as the work is completed. Show the mortgage lender your contractor’s bid and let the lender know how much the contractor wants upfront to start the job. Your mortgage company may want to inspect the finished job before releasing the funds for payment to the contractor.

If your home has been destroyed, the amount of the settlement and who gets it is driven by your policy type, its specific limits and the terms of your mortgage. For example, part of the insurance proceeds may be used to pay off the balance due on the mortgage. And, how the remaining proceeds are spent depend on your own decisions, such as if you want to rebuild on the same lot, in a different location or not rebuild at all. Tthese decisions are also driven by state law.

Some contractors may ask you to sign a “direction to pay” form that allows your insurance company to pay the firm directly. This form is a legal document, so you should read it carefully to be sure you are not also assigning your entire claim over to the contractor. When in doubt, call your insurance professional before you sign. Assigning your entire insurance claim to a third party takes you out of the process and gives control of your claim to the contractor.

When work is completed to restore your property, make certain the job has been completed to your satisfaction before you let your insurer make the final payment to the contractor.

Your check for additional living expenses (ALE) has nothing to do with repairs to your home. So, ensure that this check is made out to you alone and not your lender. The ALE check covers your expenses for hotels, car rental, meals out and other expenses you may incur while your home is being fixed.

You’ll have to submit a list of your damaged belongings to your insurance company (having a home inventory will make this a lot easier). Even if you have a replacement value policy, the first check you receive from your insurer will be based on the cash value of the items, which is the depreciated amount based on the age of the item. Why do insurance companies do this? It is to match the remaining claim payment to the exact replacement cost. If you decide not to replace an item, you’ll be paid the actual cash value (depreciated) amount for it.

To get fully reimbursed for damaged items, most insurance companies will require you to purchase replacements. Your company will ask for copies of receipts as proof of purchase, then pay the difference between the cash value you initially received and the full cost of the replacement with an item of similar size and quality. You’ll generally have several months from the date of the cash value payment to purchase replacements; consult with your agent regarding the timeframe.

In the case of a total loss, where the entire house and its contents are damaged beyond repair, insurers generally pay the policy limits, according to the laws in your state. That means you can receive a check for what the home and contents were insured for at the time of the disaster.

Next steps: We can’t reinforce it enough – claims are easier to make when you have a home inventory ready!


National Uniform Claim Committee, hcfa claim forms.#Hcfa #claim #forms


NUCC Survey on Usage of 1500 Form

The National Uniform Claim Committee (NUCC) is conducting a survey to gather information on the current usage of the 1500 Health Insurance Claim Form (1500 Form), both as a paper form and as a print image. Information from this survey will be used by the NUCC in its general work on the professional claim and its data content. This survey is not an indication of any specific changes being considered for the 1500 Form.

The survey will close at the end of the day Friday November 10, 2017.

The questions should take approximately 5-10 minutes to complete, although you may need to spend additional time compiling data on your use of 1500 Form prior to answering the questions. This PDF of the survey questions will assist you in gathering the information for the questions. (Note: Responders will only answer the set of questions in their stakeholder group.) All responses are confidential. We appreciate your feedback.

If you have any questions about this survey, please email This email address is being protected from spambots. You need JavaScript enabled to view it. .

July 2017 Taxonomy Code Set Updates Released

The NUCC has released the semi-annual update to the Health Care Provider Taxonomy code set, which will go into effect on October 1, 2017. The complete code set, including the list of new and modified codes, is available under the “Code Sets” tab. The PDF download version of the code set is also available there.

When reviewing the Health Care Provider Taxonomy code set online, revisions made since the last release can be identified by the color code; new items are green and orange items are modifications.

Questions or comments about the code set or the revisions can be emailed to: This email address is being protected from spambots. You need JavaScript enabled to view it. .

Release of 2017 1500 Instruction Manual

The NUCC has released its annual, updated version of its 1500 Health Insurance Claim Form Reference Instruction Manual. The updated instruction manual, Version 5.0 7/17, goes into effect immediately and is available under the 1500 Claim Form tab.

All changes that were made to the instructions following the July 2016 release have been incorporated into this version of the instruction manual. A change log showing all of the updates is also available under the 1500 Claim Form tab. Any interim changes, clarifications, or corrections to the instructions following this release will be posted on the NUCC website.

For more information on the 1500 Health Insurance Claim Form Reference Instruction Manual, email This email address is being protected from spambots. You need JavaScript enabled to view it. .

Do NOT email, fax, or mail completed 1500 Claim Forms to the NUCC. The NUCC does not process claims. Send completed forms to the appropriate payer.

1500 Claim Form Renewed by OMB

The Office of Management and Budget (OMB) has completed its review and renewed the 1500 claim form for use by government programs, most notably Medicare. The form has been renewed in its current format, with no changes to the OMB number, data fields, or other text on the form.

Forms with the 02/12 NUCC approval date and OMB number 0938-1197 (02-12) remain in effect and valid.

The renewal of the 1500 claim form by OMB occurs every three years and is outside the scope of the NUCC’s work.

Resources for Implementing the 02/12 1500 Claim Form

Payers may begin accepting the 02/12 1500 Claim Form as of January 6, 2014. The following resources will assist your organization in implementing the revised form:

Submitters of the form should follow up with their specific payer(s) regarding their transition timeline information.

Questions about the DSMO Process?

The Designated Standards Maintenance Organizations (DSMO) have created a presentation “Understanding the HIPAA Processes” to provide information on the HIPAA transactions, code sets, and operating rules processes under HIPAA. The presentation was developed to satisfy an industry need to have in one concise document the process of how to request changes to HIPAA mandated standards.

The DSMO includes three American National Standards Institute (ANSI) Accredited standard development organizations ‐ Accredited Standards Committee (ASC) X12, Health Level Seven (HL7) International, and the National Council for Prescription Drug Programs (NCPDP), and three data content organizations ‐ the American Dental Association (ADA) Dental Content Committee (DeCC), National Uniform Billing Committee (NUBC), and National Uniform Claim Committee (NUCC). The DSMO reviews change requests to the HIPAA designated standards and requests for new standards and code sets to be adopted.

Who Are We?

The National Uniform Claim Committee (NUCC) is a voluntary organization that replaced the Uniform Claim Form Task Force in 1995. The committee was created to develop a standardized data set for use by the non-institutional health care community to transmit claim and encounter information to and from all third-party payers. It is chaired by the American Medical Association (AMA), with the Centers for Medicare and Medicaid Services (CMS) as a critical partner. The committee is a diverse group of health care industry stakeholders representing providers, payers, designated standards maintenance organizations, public health organizations, and vendors.


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