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...Instructions for completing the cms claim form center of medicaid and medicare services must be used to bill sfhp medical is by physicians allied health professionals submit claims all items completed unless otherwise noted in these a with field descriptions included link below required description requirements location optional type insurance insured s id number enter member digit as it appears on card do not use ssn or cin when billing if you know patient can log onto our provider portal look up insert name indicated submitting newborn infant using mother box rendered an may billed month birth after only twin b reserved local date check male female applicable see above address complete telephone relationship self child are status d other information policy group employer school plan program c condition relation medi cal crossover carrier code there another benefit yes no signature authorized person current illness first symptom injury pregnancy lmp onset accident last menstrual perio...