OfficeMate Home Office User's Guide - OfficeMate Software Solutions

Processing UB-04 Claims
Chapter 11 Processing Insurance Claims
Note,
cont.
• Boxes 63–64: Blank, but you can edit these boxes.
• Box 65: Blank, but you can edit this box.
• Box 66: Always 9.
• Box 67(a–c): ICD-9 code assigned on the fee slip
• Box 67(d–q): Blank, but you can edit these boxes.
• Boxes 68–75: Blank, but you can edit these boxes.
• Box 76: NPI Number and UPIN # fields on the Provider/Staff
tab of the Business Names window. Qual. is always 1G.
• Box 80: Blank, but you can edit this box.
• Box 81CC(a–d): Blank, but you can edit this box.
Note
Do not click Reset. Clicking Reset forces the UB-04 to, once again,
collect information from the various parts of OfficeMate and overwrites
any information that you added, modified, or deleted manually on the
UB-04 form.
Click Print to print the UB-04 form.
Note
Since the layout of the fields on the UB-04 is wider than most
printers will allow, you must use a printer that supports
edge-to-edge printing. If you attempt to print a UB-04 on a printer
that does not support edge-to-edge printing, not all of your input
will print along the left and right margins.
Click OK to save and close the UB-04 form.
If you want to preview or print UB-04 claims go to Printing UB-04 Claims on
page 461. If you want to create a batch file and export claims, go to Exporting
UB-04 Claims on page 461.
460 OfficeMate Home Office User’s Guide