Which form should the billing and coding specialist transmit to the insurance carrier for reimbursement of inpatient hospital services?

• A. UB-04 form
• B. CMS 1500 claim form
• C. Electronic submission
• D. Paper claim form

Answer: (A)

Billing inpatient hospital services uses the UB-04 form because these are facility claims. The UB-04 (also known as CMS-1450) is the standard form hospitals use to report patient details, admission and discharge dates, diagnoses, procedures, and revenue codes for inpatient services and other institutional charges. The CMS 1500 form is used for professional claims, such as physician or outpatient clinic charges, not for inpatient facility charges. Claims can be submitted electronically or on paper, but the specific form for inpatient hospital reimbursement is the UB-04.