Certified Revenue Cycle Representative (CRCR) Practice Exam

What is the standard claim form used for billing by hospitals and nursing facilities called?

1. UB-04

2. 1500

3. COST REPORT

4. REMITTANCE NOTICE

The correct answer is: UB-04

The standard claim form used for billing by hospitals and nursing facilities is called the UB-04. This form is specifically designed to capture the details of the services provided in institutional settings, such as hospitals and skilled nursing facilities. It includes essential information such as the patient's demographic data, the types of services rendered, diagnosis codes, and other details relevant to the claim for reimbursement from payers. The UB-04 is critical for ensuring that healthcare providers can accurately communicate the medical services provided and request payment in a standardized format that insurers can process. This claim form replaces older forms like the UB-92 and is widely used in the healthcare industry for billing various types of inpatient and outpatient services provided by these institutions. On the other hand, the other options represent different billing forms or documents; for instance, the 1500 form is primarily used for billing by individual medical providers, not institutions. The cost report pertains to the overall costs incurred by a healthcare facility but is not specifically a claim form for individual patient billing. A remittance notice is a document sent by a payer to the provider detailing how a claim was processed and paid, rather than a claim form itself.