Uniform Bill (UB) - Form CMS-1450 for Billing

For UB Billing, this UB form has a section for patient information including name, address, birth date, admission, condition codes and occurrences. A log of patient treatments and codes is also used for the visit. This form template also takes the information of the payer and insurance company, involving revenue codes and information about worker compensation. This app also provides a notice on rules for the form.

As a provider for an inpatient at a hospital, use this app for Medicare claim processing for the purposes of hospital billing. As providers, use this claim form app to improve patient experience during the claim process. Use this digital tool that is inclusive of multiple data elements and data specifications and makes the billing and coding process more time efficient. As the billing provider, use this billing and coding app to improve the care of a medical inpatient or outpatient.