Please make sure the top portion of form has space area to enter payer name, address and enough space to type in whether it's "corrected or reconsideration" claim.

 

Placing it in the Billing tab area would be helpful, titled 1500 Template and/or UB04 Template or maybe in Pay Sources listing in "set up" ?    that might be hard to find but possibly easier for your programmers to set up for "auto populating" portions of the template. 

 

 Would be very helpful if portions of template can be auto populated when payer is entered so we don't have to remember all details like taxonomy codes, legacy identifiers,  NPI's, or all the interchange/receiver/application info., accept assignment.,etc..etc..