INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Subject: How to complete the HCFA-1500 claim form.
Effective Date: January 1, 2001, dates of service and after.
Document Description: This follow-up memorandum informs MAA's HCFA-1500 billers how to properly complete the HCFA-1500 claim form in an effort to reduce the claims inventory backlog.
To receive a copy of the interpretive or policy statement, contact Ann Myers, Regulatory Improvement Coordinator, DSHS, Medical Assistance Administration, Division of Program Support, P.O. Box 45530, Olympia, WA 98504, phone (360) 586-2337 or download from Internet at http://wws2.wa.gov/dshs/maa/Download/dmn/memos00.html, phone 725-1345, TDD 1-800-848-5429, fax (360) 753-7315, e-mail mailto:MYERSEA@dshs.wa.gov.
November 30, 2000
Leslie Saeger, Manager
Regulatory Improvement Project