Printing CMS-1500 form and Patient Receipts for Self-Pay patients

If you would like to print a CMS-1500 form for a Self-Pay patient please follow the steps below. Make sure to add the insurance to the private insurance list without the Payer ID and add the claim address where the patient is going to mail the CMS-1500 form to print.

After adding the insurance into the private insurance database, please go to the patient chart and add this insurance to the patient insurance profile, and save it.

Once the progress note has been finalized an encounter will be generated, ready for review, and for you to post. Once you post the encounter, a claim will be created with a ready-to-print status. Please go to the dashboard on the home screen, to the tasks in the upper left corner, and select Claims ready to be printed on paper.

Check the box of the claim that you want to print. Click on the blue Print Claims button, and select Print Claims from the dropdown. 

Once you click on print claims, in the next screen choose the type of paper and whether you want to log this claim or not. 

Once you click submit, a copy of the CMS-1500 form in a PDF format will be downloaded to your computer. You will be able to print the claim and provide it to the patient. 

Printing Itemized receipt

If the patient would like a receipt, please follow the steps below:

1. Post a patient payment
2. Select the Print Receipt Box (bottom right corner)
3. Click on Post (see image below)

This will generate a patient receipt for you to review and give to the patient.

For any further questions, please post a comment or reach out to our technical support by sending an email to techsupport@ezderm.com or call 877.443.9337,2