Direct billing form 2026

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  1. Click ‘Get Form’ to open the direct billing application in the editor.
  2. Begin by entering the date of arrival at the top of the form. This is crucial for processing your request on time.
  3. In the 'Contact Information' section, provide your name, phone number, fax number, and email address. Ensure all details are accurate for effective communication.
  4. Fill in the name of your organization and its nature. This helps establish your business identity.
  5. Complete the billing address section thoroughly to avoid any delays in processing.
  6. List three recent hotels or vendors where you have established credit. Include their names, locations, dates used, amounts billed, and contact information.
  7. Provide your bank references by filling in the bank name, telephone number, address, account number, type, officer's name, and average balance.
  8. Indicate your direct bill instructions by checking the appropriate boxes and specifying any amount of credit applied for.
  9. Authorize individuals who can sign charges by listing their names and titles in the authorization section.
  10. If applicable, complete the tax exempt status section with your tax exempt number and attach a certificate if required.

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Direct Billing is an arrangement whereby guest charges are transferred to an Accounts Receivable account for payment. Typically, when a guest uses direct billing, an invoice is sent directly to the guests company or other sponsoring organization.
The CMS-1500 is used for billing professional services by non-institutional providers, while the UB-04 (CMS-1450) is used by institutional providers, like hospitals, to bill for inpatient and outpatient services.
Providers sending professional and supplier claims to Medicare on paper must use Form CMS-1500 in a valid version. This form is maintained by the National Uniform Claim Committee (NUCC), an industry organization in which CMS participates.
Service-based organizations that provide ongoing work, such as monthly consulting work, might use direct billing so invoices are emailed to clients automatically. In healthcare, a clinic might choose to bill patients directly rather than involve insurers.

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