Hi Rob, I initially printed the CMS1500 form and it was confusing for the patient and the insurance company. They would try to send us the reimbursement. I very rarely see Medicare as they know they will not be reimbursed for my visit. All of mine are pay at the time of service and I have no billing. I print the invoice and give it to them. If they have BCBS NC we give them that particular form, otherwise they do that on their own. My practice too is based off of another and this is how he does it too. So far it really works. Of course some companies balk at paying since I am not a provider but most are out of network and those companies love paying me verses a full price practice. Keep me posted and let me know if you have any questions. Alex