Patient/Insured Info Screen – Features

The Patient/Insured info screen represents the top half of the CMS-1500 form.  See Entering Claim Data and Printing Your First Claim

Print Form & Data

How do I print the CMS-1500 form along with my data?

EZClaim allows for printing the CMS-1500 form along with the patient data. Check the box in the lower right corner to print form. To set this feature as a default setting, go to Tools > Options > Default Print Options and check the box that says ‘Print the form along with the data’.

Patient Signature on File

If a patient’s signature is on file, some carriers require you to enter the words “Signature on File” on the form. Place a check in the ‘Signature on File ‘boxes to print “Signature on File” in the appropriate fields.

Patient Signature (Box 12 on the CMS form) also has the option of printing the current date or a date that you enter.

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Patient Notes