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HCFA 1500

Several payers still require submission of paper claims on the HCFA 1500 form. TFM has simplified the creation of HCFA forms by automatically extracting all of the relevant patient and encounter information from the database and then inserting it into a PDF file. All of the encounter details will be placed in the correct printable location in the file and when the standard HCFA 1500 form is loaded into you printer, it will print will all information in the appropriate location. Please review the following sections:

The HCFA Process   The HCFA Editor   The HCFA Editor Fields   The HCFA Output File   The HCFA Form Adjuster  

The HCFA Process

TreFre Medical provides the capability to automatically create HCFA 1500 documents formatted to print directly on a standard HCFA 1500 form. After an encounter and associated claim has been created, all relevant information is automatically gathered and inserted in the document in the appropriate location for printing. The entire process is as follows:

Since printers typically have different margins and other print settings, it is critical that the printer used to print the PDF documents be tested and aligned with the HCFA 1500 form. If this is not done, the printed fields may not align with the text on the actual paper form. TFM provides an adjustment tool that can be utilized to test and create printer settings for any printer in the office. Automatic use of these settings enables any printer to print HCFA 1500 forms correctly. Refer to The HCFA Form Adjuster tool for details.


The HCFA Editor

The HCFA Editor is a screen that is used to gather all of the encounter/claim information before creating the PDF document. The layout of the screen is very similar to an actual 1500 form. When this screen is opened, all relevant information is fetched from the TFM database and displayed. Some areas provide text boxes where data can be left blank or values entered by the user. All fields are optional. Simply enter data in any fields that you would normally would if you had been manually filling out the form.

In a similar fashion to the actual 1500 form, there are 4 locations for specifying a diagnosis and 6 rows in the table. The fields in the table are identical to the rows on the printed form. The Pl and Ty table fields are the service place and service type extracted from procedure codes that have been assigned to the encounter. The CPT and Modifier codes are also extracted from the encounter/procedure information. The Diag field in the table is actually a selectable popup list. You should select the correct entry based on the 4 Diagnostic fields directly above.

Any fields on the right side of the table that are green are modifiable by clicking on them. Of course, if there happens to be a field that you wish to enter data on and it is not editable in this screen, you could always create the PDF document, print it, and then write in your information.

HCFA window

There is a checkbox directly to the left of each row in the table. By de-selecting a checkbox, the corresponding row in the table will not be used when creating the printed PDF document. This provides the capability of selectively choosing which rows of the table are processed in the document. When a checkbox is de-selected, the balance field is automatically updated by subtracting the charge from the table row.

If an encounter has more than six procedure codes assigned, when this screen is initially opened, only the first six can be displayed in the table. After the PDF document has been created, the More Procedures button can be used to list the next set of procedure codes. This process can be repeated as many times as there are procedure codes assigned to the encounter.


The HCFA Editor Fields

The various fields that are automatically inserted into the HCFA form are set by the user in several TFM windows and are extracted from the various database tables when the HCFA is first opened. This section describes the TFM source where each field on the HCFA is extracted from.


The HCFA Output File

The actual PDF output file is displayed here. You will notice that it is simply the data from the screen, placed in the appropriate locations in the file. This file is suitable for printing on the 1500 form.

If you generate a HCFA PDF file and it is empty when you print or view it, run the The HCFA Form Adjuster tool, select the Set to Default button and then the Save button to set the coordinates correctly. Regenerate the PDF file. You should only need to do this one time.
HCFA 1500 data


The HCFA Form Adjuster

All printers have different margins and other characteristics for printing. In order to print the PDF document with all fields exactly located, there needs to be a mechanism to specify printer specific locations for each field on the form. By writing the actual print locations for each cell to a saved file, the HCFA Form adjuster provides this capability. This operation is typically a one time setup operation that is performed soon after TreFre Medical is installed or when new printers are purchased.

The HCFA Adjust tool is accessed from the File->HCFA Adjust menu item. The screen is displayed below.

HCFA 1500 data

The various fields and selectors on the screen allow you set the exact location for each field to be printed on the form. The Cell Name field indicates which field is the current field for adjustment and maps directly to an individual labeled cell on the printed form. The Previous and Next fields change the current field accordingly. The Row# selects a specific row on the 1500 form to be the current row. The Left, Right, Up, and Down selectors move the current field one printable location.

The four buttons in the middle manipulate all rows or cells and could be used if entire page adjustments need to be performed. They do the following:

The four buttons at the bottom allow for file loading and saving as well as exiting this screen. They do the following:

When this screen is opened, all field locations are set to 0 by default. The Read button should always be used to read in the current saved values. The Set To Default button can be used to set the field locations to some initial default TFM location values but beware that the combination of Set To Default followed by a Save will destroy any settings previously saved. From either of these initial locations, you can begin to make adjustments.

A typical use of the HCFA Adjust tool would be the following:

Once adjusted and saved, there should be no need to re-adjust this information unless a new printer is installed or the printer settings change.


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