Excel PDF Form Filler is a tool that generates the new CMS 1500 02/12 form with data populated from an excel spreadsheet.
When you select a row on the Excel spreadsheet and click on “Generate PDF”, it generates a pdf form populated with the data from the excel spreadsheet.
You can print multiple claims at once by selecting the columns you would like to print.

The pdf form has a functionality to turn the layer “on” or “off” so that you’re able to print with or without the CMS 1500 form. In other words, you can print data-only without the form if you would like.

For limited time, the CMS 1500 02/12 new fillable and Excel forms (including capability to print data only) are available for only $29.99.

We’ll e-mail you the CMS 1500 02/12 new fillable and Excel forms as soon as we receive payment.

***Please note that only Windows Operating Systems are supported at this time.

The NUCC has approved a transition timeline for the version 02/12 1500 Health Insurance Claim Form (1500 Claim Form).  In June, the NUCC announced the approval of the updated 1500 Claim Form that accommodates reporting needs for ICD-10 and aligns with requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type 3.

The NUCC approved the following transition timeline at its in-person meeting in Chicago on August 1, 2013.

• January 6, 2014: Payers begin receiving and processing paper claims submitted on the revised 1500 Claim Form (version 02/12).
• January 6 through March 31, 2014: Dual use period during which payers continue to receive and process paper claims submitted on the old 1500 Claim Form (version 08/05).
• April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12).

This timeline aligns with Medicare’s transition timeline.