UB04 Form – What is a UB04 Form, Where Do I Get One, and How Do I Fill it Out?

Do you should get a UB04 type accomplished for an insurance coverage firm?  What is a UB04 type?  Where do you discover one?  And how do you fill it out?  We run throughout these questions typically on this planet of medical billing.  Most medical medical insurance claims are filed on CMS 1500 types (typically known as HCFA types).  These are extra widespread to most individuals.   Many billers do not know when to make use of the CMS types and when to make use of the UB 04 types.

The UB04 declare type is utilized by services relatively than physicians for his or her medical insurance billing.  Hospitals, rehabilitation facilities, ambulatory surgical procedure facilities, clinics, and so on must invoice their providers on the UB04 type with a purpose to receives a commission.  Physician billing is performed on the CMS 1500 declare types. 

Every as soon as in awhile we get a name from a one that is attempting to get an insurance coverage declare paid and they’re informed by the insurance coverage firm that they need to file the declare on a UB04 declare type.  These folks haven’t got a clue what this way is or how one can full it.  They might have needed to admit a liked one into a drug and alcohol rehab facility and now discover that the power would not take part with their insurance coverage plan.  These services typically do not file UB04 types and cannot assist the household get reimbursed by the insurance coverage firm.

Many instances the household has paid up entrance for the providers of the power and at the moment are attempting to get the insurance coverage firm to reimburse them.  The insurance coverage coverage might pay out of community however the declare should be filed accurately on a UB04 type.  Often instances persons are attempting to gather many 1000’s of on the declare.  Required fields on the UBO4 type embrace rev codes, worth codes and sort of invoice.  What do you place in these fields?   These types may be very complicated.  Where do you get the right data to finish the types?  And which fields are required on the shape?  If the power doesn’t have a UB04 type to fill out, the place do you get one? 

Unfortunately the solutions will not be simple.  The Rev codes characterize the process codes.  The sort of invoice is a three digit quantity that represents the kind of facility, the invoice classification and the frequency of the invoice.  The worth codes are required fields solely in sure conditions.  It is very tough to finish these types accurately with out earlier expertise or correct coaching.  Another catch is that the types had been modified in May 2007 to permit to be used of the NPI quantity.  You should perceive NPI numbers fully to find out the place you have to be getting into a person NPI quantity or a group NPI quantity.  And whenever you attempt to discover UB04 types on the market, you discover they’re out there in containers of 2500.

If you end up needing to file a declare on a UB04 type and do not know what you’re doing, ensure you look into it absolutely.  Claims are sometimes denied time after time for data being incomplete or incorrect.  If your declare is for a lot of cash, you might not need to wait months for cost.

Copyright November 2008 – Alice Scott



Source by Alice Scott

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