Boxes 12 & 13 of the CMS 1500 form are very important and often overlooked. When I say overlooked, I mean most people do not understand the importance of a box, and just blindly fill them in. It is important to understand what they mean, and make sure they are complete because they can seriously affect demand payment if not done right

Box 12 is information box .. Many believe that if you are not to give out any information that you can just leave this blank. Others think you just stand “signature on file” where you’re good. Well, are not correct. Many carriers will not release payment if this box is not complete. But just stick “signature on file” it is not right either. You really need to know the patient’s signature is on file with the provider you are billing for. The patient should have signed Disclosure statement when they first came. It is usually part of the initial paperwork they complete. If you are a billing service, you should ask the providers when you are set up to make the collection if they have these statements recorded in all patients so that you can indicate the signature files on all claims. In any case, this is an important box that you need to pay attention to.

Box 13 is a license payment to the medical provider services. If this box is completed then the patient indicated that they will all payments for services charged to be sent directly to the provider. This does not guarantee that the insurance carrier will send payment to the provider, but it indicates that the patient gives them permission. For example, if there is not a system of insurance carrier may send payments directly to the patient, even if this box is completed. And if there is in the system, but this box is not completed it is possible that the payment could go to the patient. So again, if you have the patient payment to be made to the provider, you should make sure that this box is completed.