CMS 1500: tipo de documento

Información general

CMS-1500 es un formulario estándar para las reclamaciones médicas utilizado por los proveedores o proveedores no institucionales para facturar a las operadoras de Medicare y a las operadoras regionales de equipos médicos duraderos (DMERC).También se utiliza para la facturación de algunas agencias estatales de Medicaid.

Este paquete ML está entrenado para detectar automáticamente información clave y extraer datos relevantes de este tipo de formulario. Tiene más de 80 campos que abarcan todos los tipos de información que puede contener el formulario.

Particularidades

El modelo detecta automáticamente datos como:

• Nombre y dirección del pagador.
• Dirección, teléfono y fecha de nacimiento del paciente.
• Nombre y dirección de la aseguradora.
• Fecha de la enfermedad, información de la reclamación, fecha de hospitalización.
• Naturaleza de la enfermedad, naturaleza del diagnóstico, fecha y lugar del servicio.

Extracted fields

Nota:

If you are using using public endpoints, such as https://du.uipath.com/ie/invoices, all fields are available. However, if you are using custom-trained extractors, the availability of extracted fields is dependant on the version you are currently using. You can also check the list of fields and types on any endpoint in the /info/model object. To access this, simply add /info/model to any endpoint, like so: https://du.uipath.com/ie/invoices/info/model. For an enhanced reading experience of the fields list, it's recommended to install a JSON viewer extension in your browser.

Table 1. List of extracted fields for CMS 1500

Nombre para mostrar	Nombre del campo	Tipo de campo	Tipo de contenido
Payment Name	payment-name	regular	String
Payment Address	payment-address	regular	String
Health Insurance Coverage Type	health-insurance-coverage-type	regular	String
Insured's I.D Number	insured-s-i-d-number	regular	String
Patient's Name	patient-name	regular	String
Patient's Address	patient-address	regular	String
Patient's Birthdate	patient-birthdate	regular	Fecha
Patient Relationship To Insured	patient-relationship-to-insured	regular	String
Insured's Name	insured-name	regular	String
Insured Address	insured-address	regular	String
Other Insured's Name	other-insured-name	regular	String
Other Insured's I.D.	other-insured-id	regular	String
Patient's Condition Related To Employment	condition-employment	regular	String
Patient's Condition Related To Auto Accident	condition-auto-accident	regular	String
Auto Accident State	auto-accident-state	regular	String
Insured Policy Group Or Feca Number	insured-policy-feca-id	regular	String
Insured's Birth Date	insured-birth-date	regular	Fecha
Insured's Gender	insured-sex	regular	String
Other Claim ID	other-claim-id	regular	String
Insurance Plan Name	insurance-plan-name	regular	String
Another Health Benefit Plan	another-health-plan	regular	String
Claim Codes	claim-codes	regular	String
Other Insurance Plan Name	other-insurance-plan	regular	String
Patient's Signature	patient-signature	regular	String
Patient's Signature Date	patient-signature-date	regular	Fecha
Insured's Signature	insured-signature	regular	String
Current Health Condition Date	health-condition-date	regular	Fecha
Current Health Qualifier	current-health-qualifier	regular	String
Other Health Condition Date	other-health-condition-date	regular	Fecha
Other Health Condition Qualifier	other-health-condition-qualifier	regular	String
Patient Unable To Work Date From	unable-to-work-date-from	regular	Fecha
Unable To Work To	unable-to-work-to	regular	Fecha
Name Of Referring Provider	name-of-referring-provider	regular	String
Referring Provider ID	referring-provider-id	regular	String
Referring Provider NPI	referring-provider-npi	regular	String
Hospitalization Dates From	hospitalization-dates-from	regular	Fecha
Hospitalization Dates To	hospitalization-dates-to	regular	Fecha
Additional Claim Information	additional-claim-information	regular	String
Services Outside Lab	services-outside-lab	regular	String
Charges	outside-lab-charges	regular	String
Diagnosis Codes	diagnosis-codes	regular	String
ICD Indicator	icd-indicator	regular	String
Resubmission Code	resubmission-code	regular	String
Original Reference Code	original-reference-code	regular	String
Prior Authorization Number	prior-authorization-number	regular	String
Patient's Account Number	patient-account-number	regular	String
Total Charge	total-charge	regular	String
Amount Paid	amount-paid	regular	String
Signature Of Physician Or Supplier	signature-of-physician-or-supplier	regular	String
Physician Or Supplier Signature Date	physician-supplier-signature-date	regular	Fecha
Service Facility Location NPI	service-location-npi	regular	String
Service Facility Location ID Number	service-location-id	regular	String
Billing Name	billing-name	regular	String
Billing Address	billing-address	regular	String
Billing Phone Number	billing-phone-number	regular	String
Billing NPI	billing-npi	regular	String
Billing ID	billing-id	regular	String
Patient's Phone Number	patient-phone-number	regular	String
Insured Phone Number	insured-phone-number	regular	String
Patient's Condition Related To Other Accident	condition-other-accident	regular	String
Reported ID Number	reported-id-number	regular	String
Assignment Acceptance	assignment-acceptance	regular	String
Patient Gender	patient-gender	regular	String
Federal Tax ID Number	federal-tax-id-number	regular	String
Service Facility Name	service-facility-name	regular	String
Service Facility Address	service-facility-address	regular	String
Medical Service Details - Date Of Service From	date-of-service-from	Elementos	Fecha
Medical Service Details - Date Of Service To	date-of-service-to	Elementos	Fecha
Medical Service Details - Place Of Service	place-of-service	Elementos	String
Medical Service Details - CPT/HCPCS	cpt-hcpcs-number	Elementos	String
Medical Service Details - Modifier	modifier	Elementos	String
Medical Service Details - Diagnosis Pointer	diagnosis-pointer	Elementos	String
Medical Service Details - Charges Amount	charges	Elementos	String
Medical Service Details - Days Or Units	days-or-units	Elementos	String
Medical Service Details - EPSDT Codes	epsdt-codes	Elementos	String
Medical Service Details - EPSDT Family Planning	epsdt-family-planning	Elementos	String
Medical Service Details - ID Qualifier	id-qualifier	Elementos	String
Medical Service Details - Rendering Provider NPI	rendering-provider-npi	Elementos	String
Medical Service Details - Rendering Provider Other ID	rendering-provider-other-id	Elementos	String
Medical Service Details - Supplemental Information	supplemental-information	Elementos	String
Medical Service Details - Emergency Indicator	emergency-indicator	Elementos	String

Ejemplos

Aquí tienes algunos ejemplos de formulario rellenado: