What is UB-04, and how does Resolute generate and submit hospital claims on this form?

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Multiple Choice

What is UB-04, and how does Resolute generate and submit hospital claims on this form?

UB-04 is the standardized hospital claim form used to bill facility charges for inpatient and outpatient hospital services. In Resolute, hospital claims are prepared by mapping the data from the UB-04 into the HIPAA electronic institutional claim format, 837I. Once the claim is in 837I structure, it’s transmitted through a Clearinghouse to the payer. The path—UB-04 to 837I to Clearinghouse to payer—follows the typical workflow for hospital claims. The other options mix up the form type or submission path: a remittance form is not UB-04, 837P is for professional (not institutional) claims, and submitting directly to a payer portal bypasses the standard Clearinghouse route.

UB-04 is the standardized hospital claim form used to bill facility charges for inpatient and outpatient hospital services. In Resolute, hospital claims are prepared by mapping the data from the UB-04 into the HIPAA electronic institutional claim format, 837I. Once the claim is in 837I structure, it’s transmitted through a Clearinghouse to the payer. The path—UB-04 to 837I to Clearinghouse to payer—follows the typical workflow for hospital claims. The other options mix up the form type or submission path: a remittance form is not UB-04, 837P is for professional (not institutional) claims, and submitting directly to a payer portal bypasses the standard Clearinghouse route.

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