Form UB-04 (CMS1450) Uniform Bill

Form UB-04 (CMS1450) Uniform Bill

What Is Form UB-04 (CMS1450)?

This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the UB-04 (CMS1450) Uniform Bill?
A: The UB-04 (CMS1450) Uniform Bill is a standardized form used by hospitals and other healthcare facilities to bill Medicare, Medicaid, and private insurance companies for services provided to patients.

Q: What information is included in the UB-04 (CMS1450) Uniform Bill?
A: The UB-04 (CMS1450) Uniform Bill includes information such as patient demographics, diagnosis codes, procedure codes, dates of service, and the cost of services.

Q: Who uses the UB-04 (CMS1450) Uniform Bill?
A: Hospitals, nursing homes, rehabilitation centers, and other healthcare facilities use the UB-04 (CMS1450) Uniform Bill to submit claims for reimbursement from insurance payers.

Q: Why is the UB-04 (CMS1450) Uniform Bill important?
A: The UB-04 (CMS1450) Uniform Bill ensures standardized billing practices and facilitates accurate reimbursement for healthcare services provided.

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Form Details:

  • The latest available edition released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form UB-04 (CMS1450) by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services.

Download Form UB-04 (CMS1450) Uniform Bill

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