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January 23, 2024

Paper Claim Submission Errors

We have seen a recent increase in suppliers faxing paper claims to Medical Review and Redeterminations. We cannot accept faxed claims. We can only accept paper claims that meet CMS requirements, including hard copy format and certain printing standards for ink color.

Electronic Claim Submission: CMS requires electronic claim submission for the vast majority of DME suppliers.

Exceptions to Electronic Claim Submission (not all inclusive):

  • You are a small provider. To qualify as a small provider, suppliers must have fewer than 10 full time employees. A small provider can choose to send all, some, or none of their claims electronically. The Common Electronic Data Interchange (CEDI) Claims PortalExternal Website is an electronic option for small suppliers.
  • Claims sent to Medicare when more than one other insurer was liable for payment prior to Medicare (Medicare is the third payer).
  • Claims sent by suppliers that submit fewer than ten claims a month to Medicare. The CEDI Claims PortalExternal Website is an electronic option for suppliers who submit a small volume of claims.

CMS-1500 Claim Form Printing Standards and Print File Specifications

The National Uniform Claims Committee (NUCC) has approved the printing standards for Form CMS-1500 (08-05) paper claim. The form must be printed using red "dropout" ink or an exact match so that image processing technology can recognize the information entered in each field of the claim form. We may only accept CMS-1500 Claim Forms that meet the printing standards published in Pub. 100-04, Medicare Claims Processing Manual, Chapter 26External PDF.

Mailing Address

Suppliers who meet one of the exceptions to electronic claim submission should mail paper claims to the following address:

CGS – Jurisdiction C
P.O. Box 20010
Nashville, TN 37202

Resources and Education:

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