| Resources > Advance Beneficiary Notice |
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Full color paper proofs of the UB-04 form are available from:
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The Official UB-04 Data Specifications manual is available from the National Uniform Billing Committee (NUBC). Cost is $150/year for a printable electronic manual or an electronic version with updates. Order online or download the request form and then send to address below:
American Hospital Association
National Uniform Billing Committee
P.O. Box 92247
Chicago, IL 60675-2247
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Chapter 25 UB-04 Instructions
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UB-92 Handbook for Hospital Billing and/or UB-04 Handbook for Hospital Billing:
- Go to: www.aha.org
- Go to Red Banner, half way down the page and look for SERVICES.
- Visit the AHA ONLINE STORE.
- Then use the SEARCH box & type BIRKENSHAW or BILLING
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For a copy of this form, visit the National Uniform Claim Committee website : www.nucc.org
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More information on EDI is located on the Washington Publishing Company website: www.wpc-edi.com
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Please contact us at toll free (866) 447-221 or via email at info@bridgefront.com.
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