Using Adobe Acrobat Reader, enter the information from the case scenario into the appropriate field on the corresponding form.
Refer to your readings for Physician and Hospital Medical Billing for information on CMS-1500 and UB-04 form locators and required information.
Instructions For the CMS-1500 forms:
Enter your name and date in the box in the upper left of the form.
Enter the Case ID in the box in the upper right.
Complete all pertinent fields according to the data in the case scenarios by following the Instructions for Completing the CMS 1500 forms you downloaded in Step 4.
Instructions For the UB-04 forms:
Enter your student name, the date, and the Case ID in the Field 1 on the form.
Complete all pertinent fields according to the data in the case scenarios and the Instructions for Completing the UB-04 forms you downloaded in Step 4.
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