CMS-1500 Health Care Provider Q&A
Pre-Webinar Survey

To help us better prepare for the CMS-1500 Provider Q&A webinar, please share your questions.

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* 1. I have questions regarding the following CMS-1500 topics (check all that apply)

Filling out the CMS-1500 form

Medical Narrative Report Template and requirements

Registering for electronic submission

Forms being discontinued

CMS-1500 implementation dates

How to find out about payer objections to my bill

How and when to file a dispute for non-payment of my bill

Other (please specify)

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* 2. If you have questions about filling out out the CMS-1500 form, please share them in the spaces below.

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* 3. If you have questions about the Medical Narrative Report Template and requirements, please share them in the spaces below.

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* 4. If you have questions about registering for electronic submission, please share them in the spaces below.

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* 5. If you have questions about current forms being discontinued, please share them in the spaces below.

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* 6. If you have questions about CMS-1500 implementation dates, please share them in the spaces below.

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* 7. If you have questions about payer objections to your bill, please share them in the spaces below.

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* 8. If you have questions about how and when to file a dispute for non-payment of a bill, please share them in the spaces below.

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* 9. If you have questions on other topics related to the CMS-1500 transition, please share them in the spaces below.

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