What does UB stand for in Medical Billing

In medical billing, the term UB stands for Uniform Billing. As the name Uniform Billings suggests, UB simply refers to the process of making medical billing both uniform and streamlined for reimbursement purposes. The UB plays an important role in billing insurance companies to compensate the doctors for their medical services.

The UB-04 Form

The UB-04 (CMS 1450) form replaced the UB-92 form in 2007. The CMS developed UB-04 intending to eliminate the complexities in billing claims due to the lack of uniform billing. Keeping this in mind new fields were added in the UB-04 covering all information that is required to bill the insurance payers.

The UB-04 is printed with “red ink” on a standard white paper. However, nowadays, hospitals are switching to the electronic version of UB-04 for convenience.

Structure of UB-04

The UB-04 form has 81 fields or Form Locators (FL). Each Form Locator (FL) focuses on a specific set of information. For example, FL 1—Billing provider name, street address, city, state, zip, telephone, fax, and country code, FL 3—Patient control number and the medical record number for your facility and FL 6 —Statement from and through dates for the service covered on the claim, in MMDDYY (month, date, and year) format. Similarly, other fields also ask for the information related to billing claims. The last form locator in the form is FL 81—Taxonomy code and qualifier.
The American Hospital Association and the National Uniform Billing Committee are responsible to design and modify the Official UB-04 Electronic Data Set and publish the UB-04 Manual.

Tips to Avoid Denials

The long list of form locators in the UB-04 form is quite daunting and filling such a long-form requires a lot of concentration along with the correction information. Turning in the incorrectly filled form may result in denials. Therefore, while billing the forms, the biller must go through the UB-04 form to cross-check the available information for each filed. Here are a few tips to help you avoid any denials.

• Verification: Before filling the form make sure to verify the required information with the insurance payer.
• Fill in Correct Details: If you are submitting the paper version of the UB-04 form then make sure to fill the details correctly. There’s no scope of reviewing the form and correcting any mistakes. However, it is advisable to switch to the electronic UB-04 to avoid any mistakes.
• Insurance Information: Write the patient’s name the way it appears on the insurance card.
• Correct Codes: It is important to mention the correct CPT/HCPCS codes using modifiers for various procedures. Any mistake in codes may result in a ‘false alarm for discrepancy’ causing a delay in reimbursement.
• Fill the National Provider Identifier (NPI): Make sure to fill the NPI in form locators—56, 76, 77, 78, and 79 as demanded.
• Review the Form: Make sure to review the form and verify all the details before submitting it.
• Switch to Electronic UB-04: Electronic submission of bill claims is error-free, quick and reliable. Using the electronic form gives the assurance of maximum reimbursement with a low denial rate.