Certified Outpatient Coder (COC) Practice Exam 2025 – Comprehensive Test Prep

The UB-04 claim form is specifically designed for submitting hospital facility charges. It is used by institutional providers, such as hospitals and other healthcare facilities, to bill for services provided to patients. This form includes detailed information about the institutional provider, the patient, the services provided, and the charges associated with those services.

The format of the UB-04 accommodates the variety of information that is unique to facilities, such as accommodation types, revenue codes, and other essential details pertinent to claims for hospital services. In contrast, the CMS-1500 and HCFA-1500 forms are used primarily for outpatient services provided by non-institutional providers, like physicians and some other healthcare professionals. Claim Form 22 is not a standard claim form recognized for health services billing and does not apply in this context.

By using the appropriate form, healthcare providers can ensure that they meet the requirements for reimbursement from Medicare, Medicaid, and private insurers, thus streamlining the billing process for facility services.