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UB-04 Fill & Print

Introducing the ideal solution for Professional Health Care and Medicare/Medicaid Claims.

Fill out UB-04 (CMS 1450) forms on your computer & print the data.

* Licenses (# of users):

Backup Disk:

UB-04 eDirect

Key Features & Benefits

  • 100% HIPAA Compliant UB-04 (CMS-1450) forms
  • No monthly fee. Just a one-time purchase that includes FREE Technical Support and Software updates
  • Simple interface with HELP BOXES for ease of use and learning that act as a tutorial
  • Creates templates for speed of completion and to eliminate repetitive entries
  • Save and load claims from your hard drive or network
  • Print onto purchased forms or print the form in either black & white or color
  • Advanced Printer Alignment - calibrates the form with your printer perfectly
  • Batch Printing print multiple claims with one click
  • AutoFill for repetitive transactions in rows 1 - 22 of Boxes 42 - 49
  • Administrative Security Login to further protect your claim files and enhance HIPAA Compliance through Privacy and Security
  • Enhanced Importation/Exportation allows importation from ms-excel (MS Excel) and MS Access (MS Access), as well as exportation to MS Excel, MS Access, MS Word (MS Word), and PDF PDF, allowing entry-less claim creation

Special Note:

Our software does not in any way shape or form change your system’s settings, nor does it transmit any personal data. Our software is 100% HIPAA compliant. Please refer to the installation process and our uninstallation process for more information.

Before you buy

14-Day Trial

Our UB-04 software functions on any Windows operating system from Windows 2000 to Windows 11. The software functions on networks or stand-alone personal computers and is compatible with all printers.

After the 14-day trial, you can purchase a license and simply register the software to retain all functionality.

After you buy

30-Day Money-Back Guarantee

That's right. No questions asked. You will have up to 30 days after your purchase to return your product. Your refund will be issued and your registration code will expire. You can simply uninstall the software.

Our support staff is available during regular business hours (8am – 4pm EST) and can be contacted via email at This email address is being protected from spambots. You need JavaScript enabled to view it. or by phone 1-866-829-2763.

30 day money back guarantee

What is UB-04 (CMS 1450) in Medical Billing and why is it so important?

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.

Who Can Bill Claims using the UB-04 form?

Any institutional provider and supplier can use the UB-04 for billing medical claims. This includes the following:

  • Community mental health centers
  • Comprehensive outpatient rehabilitation facilities
  • Critical access hospitals
  • End-stage renal disease facilities
  • Federally qualified health centers
  • Histocompatibility laboratories
  • Home health agencies
  • Hospices
  • Indian Health Services facilities
  • Hospitals
  • Organ procurement organizations
  • Outpatient physical therapy services
  • Occupational therapy services
  • Speech pathology services
  • Religious non-medical health-care institutions
  • Rural health clinics
  • Skilled nursing facilities