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ICP Annual Workshop October 2016 MD wise UB04 Billing and Claim ProcessingExclusively serving Indiana families since 1994. APP0216 (9/15)Agenda Who is MD wise? Provider Enrollment: Are you an MD wise
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MDwise UB-04 billing is a standardized claim form used by hospitals, clinics, and other healthcare providers to bill or submit claims for payment to insurance companies.
Healthcare providers such as hospitals, clinics, and other facility types who are contracted with MDwise are required to file UB-04 billing forms for reimbursement of services provided to MDwise members.
To fill out MDwise UB-04 billing, providers must input necessary patient information, including demographic details, diagnosis codes, procedure codes, and other required data as outlined in the UB-04 form instructions.
The purpose of MDwise UB-04 billing is to facilitate the reimbursement process for healthcare services provided to MDwise members by submitting accurate and timely claims to the insurance company for payment.
Information required on MDwise UB-04 billing includes patient demographics, admission and discharge dates, diagnosis and procedure codes, provider information, charges for services rendered, and any other relevant billing details.
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