Follow the steps to complete your Universal Charge Data Invoice online.

1. Click 'Get Form' button to acquire the form and open it for editing.
2. Enter the clinic name in the designated field as it appears in the records.
3. Input the reporting unit number used for tracking the site or service type.
4. Fill in the service date when the service was provided.
5. Provide the primary staff number corresponding to the primary service staff.
6. Insert the client number based on the client's registration in the billing system.
7. Enter the client name exactly as it is documented in their medical record.
8. Input the procedure code for the service, ensuring it matches the associated chart note.
9. Record the group count representing the number of clients in a specific group session.
10. Document the primary staff time spent on the service and related tasks, down to the minute.
11. If applicable, enter the co-staff number and their corresponding time spent on the service.
12. Select the service location code as per the provided guidelines, ensuring alignment with the service noted in the chart.
13. If relevant, enter up to three codes for evidence-based practices or service strategies.
14. Mark the pregnancy indicator with 'Y' if applicable to the client.
15. Check the emergency indicator with 'Y' if the client is receiving emergency services.
16. Tick the 'Clk OK' box to confirm data entry progress.
17. The primary staff must sign and print their name, affirming the accuracy of all entries.
18. Complete the section for data entry done by and date entered, primarily for clerical records.
19. Once all information is accurately filled in, you can save changes, download, print, or share the completed form.

Complete your Universal Charge Data Invoice online now to ensure timely and accurate processing of services.