CMS-1500 & UB-04 Claim Controls in AllMed PM

CMS-1500 & UB-04 Claim Controls in AllMed PM

(CMS-1500 and UB-04 Claim Behavior & Printing Controls)

The Insurance Options section in AllMed PM is one of the most powerful — and least documented — areas of the system.

These options control how claims print, what data appears in specific boxes, and how electronic and paper claims behave. Many payer-specific requirements are handled here, not on the claim itself.

If a payer ever says “change how this prints” or “adjust where this value appears”, this is the first place to look.


Accessing Insurance Options

  1. From the Top Navigation Menu, click Set Up

  2. Select Insurance

  3. Open an insurance company

  4. Click the Options tab

You will see separate option sets for:

  • CMS-1500

  • UB-04

Each form has its own controls.


Understanding Insurance Options

Insurance Options:

  • Apply only to that insurance company

  • Affect all claims billed to that payer

  • Override general system behavior when required

They are designed to handle:

  • Payer quirks

  • Clearinghouse requirements

  • Box-level printing rules

  • Legacy payer demands that don’t follow standards


CMS-1500 Insurance Options

Below is a complete list of CMS-1500 options and what they control.


Claim Structure & Formatting

  • Start Claim ID With
    Adds a prefix to the claim control number.

  • Only Print 1st Pointer
    Limits diagnosis pointers to the first value only.

  • Box 31 Blank
    Leaves the provider signature box empty.

  • Field 11 Blank
    Prevents printing in Box 11.

  • 11a, 11b, 11c, 11d Blank
    Clears all secondary insurance-related fields.


Provider & Identifier Controls

  • Do Not Print NPI in Box 24J
    Suppresses provider NPI in the service line.

  • Print Referring ID in Box 23

  • Print User Name in Box 31

  • Do Not Print Provider in Box 31

  • Print Rendering Provider on Service Line

  • Do Not Print Rendering Provider

  • Do Not Print Qualifier in 33b


Address & Demographics

  • Remove Slash (/) from Patient Account #

  • Include Insurance Address in 2300B

  • Do Not Print Insured Demographics

  • Do Not Print Insured Address

  • Print Insured Address in Care Of Insurance

  • Leave Top Name/Address Blank

  • Include Patient Address in Box 32 When POS is 12

  • Do Not Print Facility


Payment & Financial Controls

  • Print Payments on 1500 Form

  • Do Not Print Secondary

  • Print Y Instead of X in Box 27


Taxonomy & Classification

  • Print Taxonomy in 24J

  • Do Not Print Taxonomy Code

  • Print Taxonomy in Billing Loop

  • Print Taxonomy in 33B


Special Formatting Rules

  • Print NDC in Box 24d

  • Do Not Print Decimal Point in DX on 1500 Form

  • Use Insurance ID Type for SBR09

  • Do Not Include SBR02 When Patient Is Not the Subscriber


Insurance Logic & Workers’ Comp

  • Print Primary ID in Box 11

  • Add POS in SV1-05

  • Include State When Condition = Employment (Workers’ Comp)


When to Adjust CMS-1500 Options

You should review these options when:

  • Claims are rejecting for formatting reasons

  • A payer gives box-specific instructions

  • Clearinghouse errors reference field placement

  • Paper claims don’t match payer expectations


UB-04 Insurance Options

UB-04 options are designed primarily for facility billing and institutional claims.


Form Locator 81CC

Allows entry of up to four code/qualifier pairs:

  • A

  • B

  • C

  • D

Used for:

  • Taxonomy

  • Provider classification

  • Payer-specific reporting


Form Locators 13, 14, 15

  • Admission Hour

  • Type

  • Admit Source

These fields control inpatient admission data when required.


Print Options (UB-04)

  • Print Insurance Address in Box 80

  • Print Insurance Address in Box 38

  • Print Payor ID in Box 51

  • Print Patient Name in Box 8B


UB-04 Totals

  • UB-04: Total on Line 15
    Controls where total charges appear on the form.


Why Insurance Options Are a “Hidden Gem”

Most billing systems force users to:

  • Manually fix claims

  • Edit forms externally

  • Re-key rejected claims

AllMed PM solves this at the insurance level, once — and every future claim benefits.


Best Practices

  • Configure options per payer, not per claim

  • Document any non-default settings

  • Change one option at a time when troubleshooting

  • If a payer changes rules, update the insurance — not every claim


Key Takeaway

If a claim:

  • Prints wrong

  • Submits wrong

  • Rejects for box placement

👉 Go to Insurance → Options first.

This section controls how claims actually behave.

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