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MARYLAND MEDICAL ASSISTANCE PROGRAM UB-04 BILLING INSTRUCTIONS FOR FREESTANDING DIALYSIS FACILITY SERVICES As of March 10, 2009, Rev. 03/09/09-Page 1 of 19 UB04 Instructions TABLE of CONTENTS Introduction

How to fill out dhmh ub04 billing instructions

How to fill out dhmh ub04 billing instructions:

1. Gather all necessary patient information, including name, date of birth, and insurance details.
2. Ensure that all services provided are accurately documented, including the date of service, procedure codes, and diagnosis codes.
3. Use the appropriate revenue codes to indicate the type of service being billed.
4. Complete all required fields on the form, including patient demographics, provider information, and billing codes.
5. Double-check all information entered for accuracy and completeness before submitting the form.

Who needs dhmh ub04 billing instructions:

1. Healthcare providers and facilities that bill for services provided to patients.
2. Medical billing specialists or coders involved in the billing process.
3. Insurance companies or payers who require the ub04 form for claims processing.

Note: It is important to consult the specific guidelines and instructions provided by the Maryland Department of Health and Mental Hygiene (DHMH) or your local healthcare authority for accurate and up-to-date information on filling out the dhmh ub04 billing instructions.

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What is dhmh ub04 billing instructions?

DHMH UB-04 billing instructions are guidelines provided by the Maryland Department of Health and Mental Hygiene (DHMH) for submitting healthcare billing claims using the UB-04 form.

Who is required to file dhmh ub04 billing instructions?

Healthcare facilities, such as hospitals, nursing homes, and outpatient clinics, that provide services eligible for reimbursement from DHMH are required to file DHMH UB-04 billing instructions.

How to fill out dhmh ub04 billing instructions?

To fill out DHMH UB-04 billing instructions, healthcare facilities need to follow the guidelines provided by DHMH. They must accurately enter the required information, such as patient demographics, diagnosis codes, procedure codes, and the amount billed for each line item.

What is the purpose of dhmh ub04 billing instructions?

The purpose of DHMH UB-04 billing instructions is to standardize the submission of healthcare billing claims to DHMH. It ensures that the necessary information is provided for proper reimbursement and enables efficient processing of claims.

What information must be reported on dhmh ub04 billing instructions?

The required information on DHMH UB-04 billing instructions includes patient demographic details, admission and discharge dates, diagnosis and procedure codes, billing amounts, and any additional supporting documentation as specified by DHMH.

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