At a glance
- Facility name/address, stable provider identifiers, common payer records, and print settings can reduce repetitive setup.
- Patient data, statement dates, bill type/frequency, revenue lines, diagnoses, condition/occurrence/value codes, and charges should be reviewed for every claim.
- A workflow is safer when staff can distinguish saved defaults from new claim data.
Good reusable elements
Facility name/address, stable provider identifiers, common payer records, and print settings can reduce repetitive setup.
Claim-specific elements
Patient data, statement dates, bill type/frequency, revenue lines, diagnoses, condition/occurrence/value codes, and charges should be reviewed for every claim.
Make copied fields visible
A workflow is safer when staff can distinguish saved defaults from new claim data. Hidden carry-forward values are a common source of repeat errors.
Institutional-claim review
- Reuse stable facility/provider information, but require fresh review of patient, bill type, dates, codes, payer, and service lines.
- Separate templates by location or billing workflow when the organization has multiple facilities.
- Update reusable data promptly after address, NPI, taxonomy, payer, or enrollment changes.
Separate facility defaults from claim facts
A reusable institutional template is safest when it contains stable facility and billing information while leaving patient, payer, bill type, dates, diagnoses, event/value codes, and service lines for deliberate review. If the organization has multiple locations or provider configurations, use named templates rather than one “master” claim. Version the template when enrollment, address, payer, or printer settings change.
Sources and verification
Use the CMS institutional-claim sources below for current CMS-1450/UB-04 guidance, then apply the payer’s rules for the facility claim.
- CMS institutional paper claim form (CMS-1450/UB-04)
- CMS Medicare Claims Processing Manual, Chapter 25
Related guides
- Understanding Type of Bill on the UB-04
- What Is the UB-04 (CMS-1450) Form?
- HCPCS and Procedure Codes on the UB-04
Try UB-04 software
For offices that prepare institutional paper claims, MedClaimSoftware’s dedicated UB-04 / CMS-1450 program can save and retrieve claims, support printing and alignment, and keep facility claim preparation in a focused Windows workflow. The software is $99/year for up to 2 computers, with a free downloadable trial. View UB-04 software.