Catalog Number : cbba1110
Title : Basic UB-04 Claim Form
Speaker : Duane Abbey

Webplay Recording Date : 10-12-2007
Webplay Price : $ 225 for two weeks viewing

Webinar Presenter: Duane C. Abbey, Ph.D., CFP

Webinar Title: Basic UB-04 Claim Form

Webinar Level: Basic

Webinar Overview - General

The UB-04 is the basic hardcopy form and is also known as the Form CMS-1450 like its predecessor, the UB-92. The paper claim form required by CMS is only accepted from institutional providers (hospitals, skilled nursing facilities, home health agencies, etc…) excluded from the mandatory electronic claims submission requirements set forth in the Administrative.

The UB-04 incorporates the National Provider Identifier (NPI) as well as additional updates. Many data locations on the UB-92 have changed on the UB-04 including bill type processing. Specifically, the three-digit type of bill (TOB) used on the UB-92 is altered to a four-digit TOB on the UB-04. Refer to the crosswalk at the end of this fact sheet to discover how data elements crosswalk from the UB-92 to the UB-04.

This Webinar provides a basic review of the UB-04, or for Medicare the CMS-1450, claim form. The various Form Locators (FLs) are discussed along with the use of this claim form for various payment systems providing for hospital payment. Basic terminology and the code sets used on the UB-04 are also briefly discussed.

Learning Objectives Include:

• To Review The General Form and Format of the UB-04
• To Understand the Concept of Form Locators (FLs) on the UB-04
• To Appreciate How This Claim Form Is Used and Adjudicated for Payment
• To Review and Briefly Discuss Key FLs on the UB-04
• To Appreciate How the HIPAA Transaction Standard/Standard Code Set Rule Has Affected the UB-04
• To Understand How Specific Payment Systems Affect the Use of the UB-04
• To Briefly Compare and Contrast the UB-04 Claim Form Relative to the 1500 Claim Form Used by Physicians/Clinics

The following are only a few of the topics to be discussed:

I. Overview of The UB-04
   a. Layout
   b. Form Locators
   c. Use of the UB-04 For Filing Claims
   d. Adjudication of the UB-04
   e. HIPAA TSC Impact
II. Review of the Main UB-04 FLs
III. Standard Code Sets Used on the UB-04
   a. CPT/HCPCS
   b. Revenue Codes
   c. ICD-9-CM Codes
   d. Condition Codes
   e. Other Code Sets
IV. Special Issues
   a. UB-04 Compared to 1500 Claim Form
   b. Variable Use of the UB-04
   c. Professional Claims on the UB-04
   d. Payment System Demands on the UB-04
V. Sources for Further Information

Prerequisites for Participating: A basic understanding of healthcare payment systems and the adjudication process for claims.

Suggested Attendees: Any and all hospital/clinic personnel that need to know about the UB-04 claim form and its use.

Attendance Certificate: Upon attending this course you will receive a 2 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.