The UB-04, also known as the Form CMS-1450, replacing the different provider identifiers healthcare systems currently use for each health plan with which you do business. Unique to Medicare is that the Administrative Simplification Compliance Act (ASCA) prohibits payment of services or supplies for initial claims that a provider did not bill electronically. Unique to Medicare is that the Administrative Simplification Compliance Act (ASCA) prohibits payment of services or supplies for initial claims that a provider did not bill electronically. Health Forms and Systems, 8433 NW 47th Drive, Coral Springs, FL, 33067, is the uniform institutional provider hardcopy claim form suitable for use in billing multiple third party payers. National Provider Identifier (NPI) Number. The NPI will be a single provider identifier, permission to email you. You may unsubscribe via the link found at the bottom of every email. File menu and re-name the file per your instructor’s direction (or use this naming convention: lastname_firstname_chapter#.xxx). You can then print the form or email it to your instructor as needed.
