Ub04 Form - What is a Ub04 Form, Where Do I Get One, and How Do I Fill it Out?

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Do you need to get a Ub04 form completed for an assurance company?  What is a Ub04 form?  Where do you find one?  And how do you fill it out?  We run across these questions often in the world of healing billing.  Most healing condition assurance claims are filed on Cms 1500 forms (sometimes called Hcfa forms).  These are more coarse to most people.   Many billers don't know when to use the Cms forms and when to use the Ub 04 forms.

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The Ub04 claim form is used by facilities rather than physicians for their condition assurance billing.  Hospitals, restoration centers, ambulatory surgical operation centers, clinics, etc need to bill their services on the Ub04 form in order to get paid.  doctor billing is done on the Cms 1500 claim forms. 

Every once in awhile we get a call from a man who is trying to get an assurance claim paid and they are told by the assurance business that they must file the claim on a Ub04 claim form.  These population don't have a clue what this form is or how to perfect it.  They may have had to admit a loved one into a drug and alcohol rehab installation and now find that the installation doesn't participate with their assurance plan.  These facilities often don't file Ub04 forms and can not help the family get reimbursed by the assurance company.

Many times the family has paid up front for the services of the installation and are now trying to get the assurance business to reimburse them.  The assurance procedure may pay out of network but the claim must be filed correctly on a Ub04 form.  Often times population are trying to derive many thousands of dollars on the claim.  Required fields on the Ubo4 form consist of rev codes, value codes and type of bill.  What do you put in these fields?   These forms can be very confusing.  Where do you get the precise data to perfect the forms?  And which fields are required on the form?  If the installation does not have a Ub04 form to fill out, where do you get one? 

Unfortunately the answers are not easy.  The Rev codes recite the procedure codes.  The type of bill is a three digit number that represents the type of facility, the bill classification and the frequency of the bill.  The value codes are required fields only in confident situations.  It is very difficult to perfect these forms correctly without old feel or permissible training.  other catch is that the forms were changed in May 2007 to allow for use of the Npi number.  You must understand Npi numbers fully to determine where you should be entering an private Npi number or a group Npi number.  And when you try to find Ub04 forms for sale, you find they are ready in boxes of 2500.

If you find yourself needing to file a claim on a Ub04 form and don't know what you are doing, make sure you look into it fully.  Claims are often denied time after time for data being incomplete or incorrect.  If your claim is for a lot of money, you may not want to wait months for payment.

Copyright November 2008 - Alice Scott

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