Fill out UB-04 (CMS 1450) forms on your computer & print the data or submit claims electronically.
- Easy to use interface with boxes for ease of use
- Save & load claims from your hard drive or network
- Creates reusable templates for speed of entry and eliminating repetition
- 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
- EDI File Creator allows the user to create a single “Print Image” eFile (electronic file) out of multiple claims, which can then be sent to a clearinghouse for Electronic, Paperless Submission
- AutoFill for repetitive transactions in rows 1 - 22 of Boxes 42 - 49
- Automatic Addition calculates charges automatically
- 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) and (MS Access), as well as exportation to , , (MS Word), and PDF, allowing entry-less claim creation
- Ideal for Institutional Health Care Claims and Medicare/Medicaid Claims
- One-time purchase fee that includes free Technical Support and Software Updates
UB-04 eDirect Software Screenshots
Definition of the UB-04 Form
The primary purpose of this revised form is to align the paper form to the electronic data standards, both the current 004010/004010A1 and the future 005010. 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’s 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.