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How to fill out a ub 04 form

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Instructions and help about ub04 form

hello everyone this is the first of mini screencast that you will have access to throughout this course to help you better understand how to fill out the ub-04 claim form also referred to as a CMS 1450 this is the claim form that is utilized for hospital billing it stands for uniform billing form 2004 so you'll hear the reference form locator FL it does not stand for Florida which is where we'd all rather be at it actually identifies what section we are referring to so this is the breakdown of the suctions that we are going to go over it covers the provider information patient demographic information condition codes occurrence codes and dates value codes revenue codes third-party information payer insured employer and diagnosis and procedure codes as well attending physician and remarks we will break this down to small sections no worries and your next screencast is going to be referencing the first section this is what the ub-04 form looks like and we will break it down in small parts

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