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What is a UB 4?

The UB-04 uniform medical billing form is the standard claim form that any institutional provider can use for the billing of inpatient or outpatient medical and mental health claims. It is a paper claim form printed with red ink on white standard paper.

What is the purpose of the CMS 1500 claim?

The CMS-1500 claim form is used to submit non-institutional claims for health care services provided by physicians, other providers and suppliers to Medicare. It is also used for submitting claims to many private payers and Medicaid programs, as well as other government health insurance programs.

What is the purpose of form HCFA 1500 or CMS 1500?

CMS-1500 Form (sometimes called HCFA 1500): This is the standard health insurance claim form used for submitting physician and professional claims to bill Medicare providers. In other words, the CMS-1500 is used for individual provider claims and is used to submit charges under Medicare Part-B.

What goes in box 31 on a HCFA?

Item 31 - Enter the signature of provider of service or supplier, or his/her representative, and either the 6-digit date (MM | DD | YY), 8-digit date (MM | DD | CCYY), or alpha- numeric date (e.g., January 1, 1998) the form was signed.

What is a UB04 form used for?

UB-04 (also known as the CMS-1450): The UB-04 is the claim form for institutional facilities, and includes the following: Hospitals. Rehab facilities, e.g. physical therapy, occupational therapy and speech therapy. General health centers, federal health centers and rural clinics.

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