General Category > General Questions

Claim Forms to Use

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TQualls:
Hi!  I am office manager for a start up express care clinic in TN.  We are opening June 1.  I was wondering which form I will need to file my paper claims on until we are live to send bills electronically.  My FNP is credentialed as a private practice provider, so I am not billing as a facility.  Would I be correct by filing a HCFA (CMS) 1500 form to each insurance company?  Or will I need to use the UB 04 forms?
Thanks!
Tammie

Michele:
The CMS 1500 would be correct for billing professional services.  The UB04 is used for facility billing.

Michele

laurajean412:
What is the difference between facility billing and professional billing?

Denise35:
Facility Billing such as Skilled Nursing Facility is basically UB04s claim forms and revenue codes.  Physician billing is on the HCFA 1500 with CPT and HCPCS.

I hope this helps,

Denise 35

laurajean412:
That does! Thank you!

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