Form online 2026

1. Click ‘Get Form’ to open the Universal Charge Data Invoice in our editor.
2. Begin by entering the 'Clinic Name' and 'Reporting Unit' in the designated fields. Ensure that these details match your records for accurate billing.
3. Fill in the 'Service Date' to indicate when the service was provided. This is crucial for tracking and compliance.
4. Input the 'Client Number' and 'Client Name' as they appear in your medical records. Accuracy here is essential to avoid discrepancies.
5. Select the appropriate 'Procedure Code' from the provided list, ensuring it corresponds with the service rendered.
6. Document the 'Primary Staff Time' and, if applicable, enter details for any co-staff involved, including their time spent on services.
7. Indicate the 'Service Location' using the correct code from your reference materials, ensuring consistency with interdisciplinary notes.
8. Complete any additional fields such as EBP/SS codes, pregnancy or emergency indicators, and check for duplicate services if necessary.
9. Finally, ensure all entries are accurate before signing off with your name and date of entry. Click ‘OK’ to finalize your submission.

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