Medi-Cal UB-04 Tutorial

UB-04 • Activity

Now it's your turn to practice filling out a UB-04 claim form.

This activity has three steps:

         1. Read the scenario.
         2. Print the claim form information.
         3. Choose whether you would like to be prompted by the tutorial or complete this activity on your own.

Choose the activity that corresponds to your provider type:

Inpatient

Outpatient