Name of Manual - Blue Cross and Blue Shield of Minnesota

Claims Filing
1500 HICF Form
Professional Claim
Submission
The paper 1500 Health Insurance Claim Form (HICF) (also
referred to as the CMS 1500) is accepted only from out-of-state
nonparticipating providers per Minnesota Statute 62J.536 and the
Blue Cross provider contracts.
The electronic transaction 837P is the only accepted claim
submission format for professional claims.
1500 HICF Manual The National Uniform Claim Committee (NUCC) has a reference
instruction manual detailing how to complete the 1500 HICF form.
The purpose of this manual is to help standardize nationally the
manner in which the form is being completed. A copy of the
instruction manual is available on the NUCC website -
www.nucc.org.
About the NUCC The National Uniform Claim Committee is a voluntary
organization whose members include representatives from major
provider, payer, health researchers, and other organizations
representing billing professionals, and electronic standard
developers.
The NUCC maintains the uniform data set known as the National
Uniform Claim Committee Data Set designed for the noninstitutional
claims. The NUCC is also a signatory to a
Memorandum of Understanding with five other organizations
designated by the U.S. Department of Health and Human Services
to collectively serve as the Designated Standard Maintenance
Organizations (DSMO) to the HIPAA Transaction Standard
Implementation Guides.
8-12 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (05/10/12)