Why is the UB-04 form more than twice the amount of fields?
This is because hospital billing has many more codes and services in their complex system. Even though the UB-04 is used to submit charges for Part-A providers, those same providers can still use the UB-04 to bill for Part-B services.
What is the AHA UB-04?
The AHA (American Hospital Association) and the NUBC (National Uniform Billing Committee) oversee and monitor the use of the UB-04 to ensure it is up-to-date and equally useful for patients, medical providers, and insurance companies.
What is UB-04 form?
The UB-04 form is popular among all insurance carriers. Although a majority of these claims must be filed electronically, the UB-04 is distinguished by white standard paper with red ink.
How many lines are there on a Ub-04?
There are 81 fields (or lines) on a UB-04 form. These are referred to as form locators or “FL.”. Each form locator has a unique purpose for the insurance carrier and provider so that they can communicate. It’s important that each of the UB-04 fields is filled out correctly to ensure a smooth process.
What is NUBC billing?
The National Uniform Billing Committee (NUBC) is a governing body which oversees forms and code for medical claims billing. Together, the AHA and NUBC design, modify, and update certain specifications for the UB-04 guidelines.
What is the AHA form?
The American Hospital Association (AHA) is a professional group that builds awareness, fairness, and quality among health care professionals and networks.
What is UB 40?
UB-40 and CMS-1500 are the two most common claim forms for submitting to insurance companies. These acronyms may not appear to say much about which is appropriate to use – both forms are printed in red “drop out” ink and contain numerous fields. However, this is where most of the similarities end. Here are some facts to help demystify these forms.
How many fields are on UB-04 form?
The UB-04 form includes 81 fields, or form locators, while the 1500 includes 33. The extent to which these will need to be completed is determined by each carrier. Nevertheless, all insurance companies will require that the information be legible and correctly aligned within each box
When was the UB-04 replaced?
According to CMS.gov, the National Uniform Billing Committee (NUCC) replaced the UB-92 with the current UB-04 in 2005. Since then, the UB-04 has been the standardized form used by hospitals, ambulatory surgery centers, nursing facilities, and other medical and mental health institutions.
Do CMS 1500 and UB-04 stand alone?
The two form types do not always stand alone. For example, if a surgeon performs a procedure in a facility such as a hospital or ASC, a CMS-1500 will be submitted for the surgeon’s services only, while a separate UB-04 form will be submitted for the use of the facility. Both forms will be needed to fully bill out for a procedure.
Who Can Bill Claims Using The UB-04?
Tips For Preparing The UB-04
- To fill out the form accurately and completely, be sure to do the following: 1. Check with each insurance payer to determine what data is required. 2. Ensure that all data is entered correctly and accurately in the correct fields. 3. Enter insurance information including the patient's name exactly as it appears on the insurance card. 4. Use correct diagnosis codes (ICD-10) and procedure cod…
A Word from Verywell
- While the UB-04 form is intended mainly for institutional providers to billinsurance companies, it's never a bad idea to inform yourself about what goes into medical claims. If you see something you don't understand, ask your insurer or provider to explain it to you.
Frequently Asked Questions
- Is there a difference between the UB-04 and an itemized bill?
An itemized medical billlists in detail all the services that were provided during a visit or stay—such as a blood test or physical therapy—and may be sent to the patient directly. The UB-O4 form is used by institutions to bill Medicare or Medicaid and other insurance companies. - What is the difference between the UB-04 and the CMS 1500 forms?
The UB-04 form is used by institutional providers, such as nursing homes and hospitals, while the CMS-1500 form is the standard claim form used by a non-institutional provider or supplier, such as a physician or a provider of durable medical equipment.2