CSM-1500 and UB-04 forms

Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

  1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.
  2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
  3. Consider the discussion and the any insights you gained from it.
  4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

Complete the following case studies using the CSM-1500 and UB-04 forms.

CSM-1500 form:

Appendix A: Case A-6 Carlos Clemenza pp. 570- 572

Appendix B: Case B-16: Earl Abbot pp. 648- 649

UB-04 form:

Appendix C : Case C-4: Harold Janovich pp. 666-667

Case-18: Tyrone Clark pp. 694-695

Assignment Expectations:

  • Length:
    • The amount of information needed for the forms
  • Structure:
    • no title or reference page required
    • address each question in a numbered list
  • References:
    • no references required
  • Format:
    • save your assignment as filled PDF documents
  • File name:
    • name your saved file according to your last name, first initial and the week (for example, “UB04-jonesb-week5”)

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