We developed the display forms of electronic claims with readability in mind and added dollar signs and commas to numbers, brackets and dashes to phone numbers, dots to diagnosis codes and slashes to dates to name some of those liberties we took. We also change fonts to get more information into a locator cell.

But strictly taken the medical claim forms as they were developed by the UB committee and CMS have precise description of the location of values in the forms. Since the forms were developed for DOT Matrix printers at 10 characters per inch, we end up with a maximum of 80 characters per line. This format has been used since the earliest days of tele-typing and computers. IBM standardized their punch card in 1928 to 80 character per line, most early computer terminals had a 80 columns by 24 rows display and printers and paper was geared to this format. There is also the well know UB format of electronic claims which consists of just saving the spool file to the printer for the UB92 form. Then it was easy to parse this file and import it into a database.

Character Assignment for the UB 04 form

To emulate this formatting we developed the 'Facsimile' mode. In this mode the forms appear just as they would have been filled with a Dot Matrix printer on tractor fed paper.

View of an Institutional claim in Facsimile Mode.

The image above shows a UB-04 in facsimile mode.