Get the free Health First Colorado UB-04 Impatient-Outpatient Hospital Billing Manual
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HEALTH FIRST COLORADOINPATIENT/OUTPATIENT BILLING MANUALInpatient/Outpatient Hospital General Billing Information ..................................................................................................................1
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How to fill out health first colorado ub-04
How to fill out health first colorado ub-04
01
To fill out the Health First Colorado UB-04 form, follow these steps:
02
Start by providing the necessary identifying information at the top of the form. This includes the patient's name, address, and health identification number.
03
Next, indicate the type of bill code in field 4. This will vary depending on the specific services provided.
04
In field 6, specify the admission and discharge dates for the patient's stay.
05
Field 10 should contain the patient's birth date.
06
Provide the patient's gender in field 11.
07
Fields 14-33 are used to indicate the patient's diagnosis and procedure codes. Enter the appropriate codes based on the medical services provided.
08
In field 34, provide the total charges for the services rendered.
09
Field 36 should contain the provider's NPI number.
10
Sign and date the form in field 39.
11
Finally, make sure to attach any supporting documentation and submit the form to the appropriate billing entity.
Who needs health first colorado ub-04?
01
Health First Colorado UB-04 form is required for submitting insurance claims for services provided to Health First Colorado (Colorado's Medicaid program) beneficiaries.
02
Any healthcare provider or facility seeking reimbursement for services provided to Health First Colorado members must use the UB-04 form.
03
Additionally, third-party billing companies handling the claims process on behalf of healthcare providers will also need to use this form.
04
It is important to note that each state may have its own specific Medicaid billing form, so it is recommended to check with the state's Medicaid agency for any additional requirements.
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What is health first colorado ub-04?
Health First Colorado UB-04 is a billing form used by healthcare providers to submit claims for services provided to Colorado Medicaid members.
Who is required to file health first colorado ub-04?
Healthcare providers and facilities that render services to Colorado Medicaid members are required to file Health First Colorado UB-04 forms for billing purposes.
How to fill out health first colorado ub-04?
Healthcare providers need to fill out the Health First Colorado UB-04 form accurately with all required information including patient demographics, provider information, diagnosis and treatment codes, and any other relevant details.
What is the purpose of health first colorado ub-04?
The purpose of Health First Colorado UB-04 is to streamline the billing process for healthcare providers submitting claims for services provided to Colorado Medicaid members.
What information must be reported on health first colorado ub-04?
Health First Colorado UB-04 requires reporting of patient demographics, provider information, diagnosis and treatment codes, dates of service, and any other relevant details related to the services provided.
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