Trauma Center Provisions Reimbursement

Trauma Center Provisions Reimbursement

  1.  Instructions for submission of Trauma Claims and Data Collection
  2. Instructions for completion of the UB-04 Claims
  3. Instructions for completion of the Excel Electronic File of the UB-04
  4. Instructions for completion of the Excel Electronic File of the UB-04
  5. Instructions for submission of the Tobacco Tax Combo Print-Out
  6. Instructions for completion of the Trauma Service County Eligibility (TSCE) (U-1) Agreement Form
  7. Instructions for completion of the Hospital Certification of Inability to Cooperate (U-2) Form
  8. Instructions for completion of the Trauma Payment Surrender Form

Excel Electronic File Template of the UB-Data

 

Frequently Asked Questions