What setting is a UB 04 form used?

The UB-04 (CMS 1450) is a claim form used by hospitals, nursing facilities, in-patient, and other facility providers. A specific facility provider of service may also utilize this type of form. ... It is not typically hospital-oriented.

What is Box 57 on ub04?

Box 57 - Other Physician ID This field is for old legacy id that the facility is currently submitting in box 51 on the UB92. Box 51 on the UB04 has been changed to the Health Plan ID, which is a national number that has not been rolled out.

What goes in box 38 on a ub04?

38 Responsible Party Name and Address Required This field is for reporting the name and address of the person responsible for the bill. 39 - 41 Value Codes and Amounts Conditional These fields contain the codes and related dollar amounts to identify the monetary data for processing claims.

The band members began as friends who knew each other from various schools across Birmingham, England. The name "UB40" was selected in reference to a form issued to people claiming unemployment benefits from the UK government's Department of Employment. The designation UB40 stood for Unemployment Benefit, Form 40.

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