Tips for Completing the UB04 (CMS-1450) Claim Form
Tips for Completing the UB04 (CMS-1450) Claim Form FAILURE TO PROVIDE VALID INFORMATION MATCHING THE INSURED’S ID CARD COULD RESULT IN A REJECTION OF YOUR CLAIM. Tips for Completing the UB04 (CMS-1450) Claim Form Page 1 of 17 Field Field description Field type Instructions 1 Facility name, Address, Telephone Number, and Country Code
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