factory assurance Billing - Billing assurance on Ub04 Forms Correctly

1500 Health Insurance Claim Form - factory assurance Billing - Billing assurance on Ub04 Forms Correctly

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Facility billing is guarnatee billing for hospitals, outpatient or outpatient clinics, and other offices such as ambulatory surgery centers. This guarnatee billing is not the same as billing for a regular physician or specialist.

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1500 Health Insurance Claim Form

Facility billing is required to be submitted on Ub04 forms instead of the more common Cms 1500 forms. The facts required on Ub04 forms is separate than the facts required on the Cms 1500.

For example, Ub04 forms need rev codes and a type of bill code that are not required on the Cms1500 form. There are also a lot of "conditional fields" that for most situations are not required to be completed. It is important that you know how to complete the Ub04 form correctly in order to get reimbursed properly from the guarnatee carrier.

Some offices may bill as both installation and pro billing. We bill for an outpatient drug and alcohol rehab installation that is owned by an Lcsw. Some guarnatee carriers have it credentialed as a installation and need the billing to be done on Ub04 forms. This is useful to our client because the installation reimbursement rate is higher than the pro reimbursement rate. But other guarnatee carriers will not credential him as a installation and he must bill services out to them on Cms1500 forms as regular therapy visits.

So you may find yourself in a position where you need to bill out on both the Ub04 and the Cms 1500 forms. In any case, it is crucial that you are completing the forms correctly.

When we first learned how to submit Ub04 forms, they were precisely still the old Ub92 forms. We had to buy a book called the Ub92 editor which is a very detailed book on what all the fields on the Ub92 form are for. It was helpful, but it precisely contained too much information. The book is hard to navigate and is precisely quite costly. The facts in it is required if you are doing in depth outpatient billing, but for the littler guy, such as outpatient clinics, it is too much info and too difficult to decipher. We receive tons of questions from people who are trying to complete a Ub04 form properly.

In order to complete the Ub04 forms correctly for installation billing, it is very important to understand the differences in billing procedures in the middle of the Cms 1500 forms and the Ub04 forms. Make sure your claims are paid correctly the first time they are submitted.

Copyright 2007- Michele Redmond

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