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Fillable 1500 and UB-04 Forms

We would like the ability to have a form that is fillable in NN for the CMS-1500 and UB-04.

  • Champ Ideas
  • Aug 5 2017
  • In Production
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  • Champ Ideas commented
    August 23, 2017 01:16

    We are in need of a HCFA-1500 and UB-04 fillable form template. 

  • Janett Chittock commented
    November 20, 2017 18:39

    Yes, thank you, and please:


       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..