Wednesday, April 6, 2011

Submitting paper claim - BCBS

Paper Claims Submission
Filing your claims electronically is both quicker and more cost effective. However, there may be times
when it is necessary to file paper claims. The CMS-1500 (or equivalent) and the UB-04 are the claim
forms accepted by BCBSF.

The National Uniform Claim Committee (NUCC) determines the data elements and design of the CMS-
1500. For additional information, including instructions on completing the form, refer to

The National Uniform Billing Committee (NUBC) and the Florida State Uniform Billing Committee (SUBC)
determine the data elements and design of the UB-04. These data elements are published in the National
Uniform Billing Data Element Specifications Manual, which contains instructions for completing the UB-04
claim form.

If you would like to enroll in the UB-04 subscription service to receive a complete UB-04 manual and
updates, visit You may also contact the Florida Hospital Association Management
Corporation at or (407) 841-6230.

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