Examples of Billing Form in a sentence
The Parties agree that billing requirements and outputs will be consistent with the Ordering & Billing Form (OBF) and also with Telcordia Technologies Billing Output Specifications (BOS).
An Explanation of Benefits from the insurance company shall be submitted with the claim to the CBO.Submit legible claims to the CBO on the CMS 1500 form, UB04 form, and for transportation on the CBO Billing Form, or an exact electronic facsimile of one of these forms.
Once adopted, hospital providers shall sub- mit outpatient hospital bills on the current version of the Universal Billing Form (UB) and use HCPCS codes and other coding schemes in accordance with the OWCP OPPS.
Every reasonable effort has been made to ensure the accuracy of the information obtained from the Uniform Claims and Billing Form (UB-82/92/04) data elements.
From the patients Master Record, click on Create Invoice .Note: Example Billing Form below.
Reserve field utilization and addition or deletion of data elements.--The council shall include in the Pennsylvania Uniform Claims and Billing Form a reserve field.
Establish a Pennsylvania Uniform Claims and Billing Form for all data sources and all providers which shall be utilized and maintained by all data sources and all providers for all services covered under this act.
Costs claimed on the Development Project Billing Form must be reviewed and attested to by an independent CPA in accordance with the Statement on Standards for Attestation Engagements as established by the American Institute of Certified Public Accountants.
The council shall include in the Pennsylvania Uniform Claims and Billing Form a field consisting of the data elements required pursuant to subsection (c)(21) to provide information on each provision of covered services sufficient to permit analysis of provider quality and provider service effectiveness within 180 days of commencement of its operations pursuant to section 4.
The minimum bill shall apply to each separate account holder receiving a service to include each individual dwelling unit.2. Billing Form.