The UB-04 claim form is primarily submitted by which type of facility for reimbursement?

The UB-04 claim form is specifically designed for institutional healthcare providers, which primarily includes hospitals. This standardized form is utilized to bill for inpatient and outpatient services rendered by these facilities. It captures detailed information about the types of services provided, patient demographics, and various charges associated with the care delivered.

Hospitals, being large institutions that often provide a wide range of services from multiple departments, utilize the UB-04 form to ensure all necessary details are included for reimbursement purposes. This includes information such as patient stay duration, diagnosis codes, procedure codes, and revenue codes, which are all crucial for determining the correct reimbursement from Medicare, Medicaid, or private insurance companies.

While clinics, nursing homes, and pharmacies may have their own specific billing requirements and related forms, they do not primarily use the UB-04 form for their billing processes, as their service structures and reimbursement needs differ significantly from those of hospitals.