American Health Information Management Association (AHIMA) Certification Practice Exam

The electronic claim format 837I replaces which paper billing form?

1. CMS-1500

2. CMS-1450 (UB-04)

3. UB-92

4. CMS-1400

The correct answer is: CMS-1450 (UB-04)

The electronic claim format 837I is specifically designed to replace the CMS-1450, also known as the UB-04 form. The UB-04 form is used by institutional providers such as hospitals and skilled nursing facilities to submit claims for services provided to patients. This form is essential for billing various healthcare services covered by Medicare, Medicaid, and private insurers. The transition to the 837I electronic format allows these claims to be submitted in a standardized electronic format, streamlining the billing process, reducing paperwork, and improving the efficiency of healthcare financial transactions. This change aligns with efforts to adopt electronic health records and improve interoperability within the healthcare system. The other options, such as the CMS-1500, are used for different types of claims, primarily from individual practitioners or non-institutional providers. The UB-92 is an older version of the hospital billing form that has been replaced by the UB-04, and the CMS-1400 is not a recognized standard billing form in this context. Therefore, understanding the specific purpose of the CMS-1450 (UB-04) helps clarify why the 837I format is the appropriate electronic replacement.