CPB Certified Professional Biller Certification Practice Exam

What type of claims does the UB-04 form submit?

1. Ambulatory services only

2. Institutional services

3. Outpatient services

4. Physician services

The correct answer is: Institutional services

The UB-04 form is specifically designed for submitting institutional claims to payers, which encompasses a wide range of healthcare facilities and services. This form is predominantly used by hospitals and other healthcare institutions to bill for services provided to patients during their inpatient stays or outpatient treatments. Institutional services include things such as room and board charges, diagnostic services, surgical services, and other services rendered by institutions like skilled nursing facilities or hospice care. The UB-04 form captures various types of data that reflect the complexity and nature of institutional care, allowing for proper reimbursement based on the services provided. This focus on institutional services is a fundamental aspect of the UB-04’s purpose, distinguishing it from other forms that cater to specific types of services, such as outpatient or physician services.