The 837I (Institutional) is the standard format used by institutional providers to transmit health care claims electronically. The UB-04 Form, also known as the CMS-1450, is the standard claim form to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed.

The official HCFA/CMS form used by hospitals and health care centers when submitting bills to Medicare and 3rd-party payors for reimbursement for health services provided to Patients covered.

Today, the UB-04 form is used in more than 98% of Medicare claims and more than 80 percent of all institutional claims, according to NUBC. Within a healthcare organization, the UB-04 functions as one of the last steps in a patient case journey but ensuring the accuracy of this form’s contents can start much earlier in a patient’s encounter. The form details all of the reimbursable care received by patients, including the relevant revenue codes for the payer. The UB-04 form is currently the best way for providers to bill payers, and most of these data elements are captured/entered at the end of a patient stay.

The primary purpose of this revised form is to align the paper form to the electronic data standards. In addition, these changes have freed up space on the UB-92 paper form for alternative reporting data. Organizations could begin using the new UB-04 paper format on March 1, 2007 and was mandated effective May 23, 2007. After May 22, 2007, the UB-92 paper claim will not be accepted – even as an adjustment claim.

The standard uniform bill (UB) for institutional healthcare providers that are used throughout the U.S. is known as the UB-04, which replaced the UB-92 following a four-year study involving National Uniform Billing Committee (NUBC) members and various public surveys. The UB form is used by hospitals, nursing homes, hospice, home health agencies, and other institutional providers.

What's The Difference Between HCFA-1500 and UB-04 forms?

Although these forms look similar, they can't be used interchangeably. The UB-04 or CMS-1450 to submit charges under Medicare Part A. The HCFA-1500 is used to submit charges covered under Medicare Part B. The Centers for Medicare and Medicaid Services is the government entity which mandates use of these forms.