Get the free Health First Colorado UB-04 Private Duty Nursing Billing Manual

HEALTH FIRST COLORADOPRIVATE DUTY NURSING BILLING MANUAL Private Duty Nursing Billing Information ..................................................................................................................................2 General

How to fill out health first colorado ub-04

How to fill out health first colorado ub-04

1. Gather all necessary information and documents, such as patient information, insurance details, and medical records.
2. Obtain a UB-04 claim form, either by downloading it online or requesting it from your healthcare provider.
3. Begin filling out the claim form by entering the patient's personal information, including their name, address, and date of birth.
4. Provide the patient's health insurance information, including their policy number, group number, and any other relevant details.
5. Indicate the dates of service for which you are submitting the claim, as well as the medical procedures or services provided.
6. Include the Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT) codes for each service rendered.
7. Provide the diagnosis codes (ICD-10 codes) that justify the need for the medical procedures or services.
8. Specify the charges for each service, including any applicable modifiers or adjustments.
9. Sign and date the claim form, indicating your responsibility for the accuracy and completeness of the information provided.
10. Make copies of the completed form and supporting documents for your records, and submit the original claim form to the appropriate health insurance payer.

Who needs health first colorado ub-04?

1. Healthcare providers and organizations who provide medical services to patients covered by Health First Colorado (Colorado's Medicaid program) are required to use the UB-04 claim form when submitting claims for reimbursement.
2. Patients who receive services covered by Health First Colorado may also need to familiarize themselves with the UB-04 form, as they may be asked to provide their insurance information and personal details when seeking medical treatment.

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