UB-04 is what?

• A. A standardized claim form used by hospitals to bill for inpatient and outpatient services.
• B. A document from a payer explaining payment details for claims processed.
• C. A forward-looking statement about future goals.
• D. A statement defining an organization's purpose.

Answer: (A)

UB-04 is the standardized claim form that hospitals use to bill payers for patient services, covering both inpatient and outpatient care. Also known as the CMS-1450 form, it collects details like patient information, admission and discharge dates, diagnosis and procedure codes, revenue codes, and charges so payers can process payments consistently. It’s the main form used across Medicare, Medicaid, and many private insurers. The other options describe documents that are not billing forms.