PDF
Word
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.
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
1
2
