Orientation Overview UB-04 Form Locators Summary
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About this course

The UB-04 billing course for extended care facilities requires about 1 hour to complete. You may access each lesson during a single session or complete the course in multiple sessions.

The course Overview familiarizes you with the organization of the UB-04 claim form and explains the significance of completing the form successfully.

The Form Locator lesson addresses each claim form locator by Number and Name, enabling you to review all or individual form locators. Each form locator offers completion explanation, including examples where appropriate. This lesson provides demonstrations of typical scenarios with accompanying completed forms.

The Summary lesson includes the codes listed on the UB-04 Desk Reference and a review of course content. The Internet Claims topic provides typical examples of using the PROMISe Internet Institutional Claim transaction.

  • Introduce the UB-04 claim form

  • Provide a block-by-block reference guide to assist extended care facilities providers in successfully completing the UB-04 claim form.

  • Show examples where clarification is required.

  • Provide user recall opportunities.

  • Demonstrate typical scenarios.


© EDS 2007