Under HIPAA, UB-04 electronic submission uses which format?

Get ready for your UB-04 Certification Exam. Study with flashcards and multiple-choice questions, each question complete with detailed hints and explanations to ensure success!

Multiple Choice

Under HIPAA, UB-04 electronic submission uses which format?

Explanation:
HIPAA requires standardized electronic claim formats in the X12N 837 transaction family, with the institutional claims using the 837I version. UB-04 (CMS-1450) is the institutional claim form used by facilities, and the 837I format is specifically designed to carry the data needed for hospital, facility, and other institutional billing—such as revenue codes, charges, units, and facility information. The 837P format serves professional claims (like physicians using CMS-1500), not UB-04 submissions. The 271 is an eligibility inquiry, not a claim submission, and XML is not the HIPAA-mandated format for these standard transactions.

HIPAA requires standardized electronic claim formats in the X12N 837 transaction family, with the institutional claims using the 837I version. UB-04 (CMS-1450) is the institutional claim form used by facilities, and the 837I format is specifically designed to carry the data needed for hospital, facility, and other institutional billing—such as revenue codes, charges, units, and facility information. The 837P format serves professional claims (like physicians using CMS-1500), not UB-04 submissions. The 271 is an eligibility inquiry, not a claim submission, and XML is not the HIPAA-mandated format for these standard transactions.

More Multiple Choice Questions
Subscribe

Get the latest from Passetra

You can unsubscribe at any time. Read our privacy policy