Patient, Type, Episode, Date Created and Claim Amount. To view the submitted form, select the “UB-04” hyperlink to the far right of the claim which will download a PDF copy. The “Export” hyperlink will create an Excel spreadsheet of just that batch. ...
This reimbursement policy applies to all health care services billed on UB04 forms (CMS 1450). Coding methodology, industry-standard reimbursement logic, regulatory requirements, benefits design and other factors are considered in developing reimbursement policy.This information is intended to serve only ...
Patient, Type, Episode, Date Created and Claim Amount. To view the submitted form, select the “UB-04” hyperlink to the far right of the claim which will download a PDF copy. The “Export” hyperlink will create an Excel spreadsheet of just that batch. ...