Change UB-04 Settings

The UB-04 tab is used to format Institutional Claims; the CMS-1500 is used for Professional Claims. The UB-04 form is used by Outpatient Rehabilitation Facilities, CORF's, hospitals and other institutions. The CMS-1500 is typically used for Physical Therapists in Independent Practice (PTIPs). Most payers follow standard settings, such as NPI, for UB-04 settings and CMS-1500, however, there are some payers who require legacy identifiers (such as UPINs and payer specific provider numbers) as well as other non-standard settings. Understanding your credentialing status and specific payer requirements is crucial in setting up billing forms correctly. Most payers post instructions on their website and their claims representatives should be able to provide the proper settings for both paper and electronic requirements.

Tip: Download the latest CMS Manual System UB04_Instructions.pdf.

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