0
reimbursement claim form submitted by:
- ambulance companies
- ambulatory surgery centers
- home health care agencies
- hospice organizations
- hospitals (emergency department, inpatient, and outpatient services)
- psychiatric drug/alcohol treatment facilities (inpatient and outpatient services)
- skilled nursing facilities
- sub-acute facilities
- stand-alone clinical/laboratory facilities
- walk-in clinics
Read more: What_is_a_UB_04_form
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