Thursday, July 5, 2012

facility insurance Billing - Billing insurance on Ub04 Forms Correctly

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Facility billing is assurance billing for hospitals, sick person or sick person clinics, and other offices such as ambulatory surgical operation centers. This assurance billing is not the same as billing for a quarterly physician or specialist.

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How is facility insurance Billing - Billing insurance on Ub04 Forms Correctly

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Facility billing is required to be submitted on Ub04 forms instead of the more tasteless Cms 1500 forms. The data required on Ub04 forms is dissimilar than the data 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 foremost that you know how to unblemished the Ub04 form correctly in order to get reimbursed properly from the assurance carrier.

Some offices may bill as both facility and expert billing. We bill for an sick person drug and alcohol rehab facility that is owned by an Lcsw. Some assurance carriers have it credentialed as a facility and need the billing to be done on Ub04 forms. This is beneficial to our client because the facility refund rate is higher than the expert refund rate. But other assurance carriers will not credential him as a facility and he must bill services out to them on Cms1500 forms as quarterly 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 undoubtedly 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 undoubtedly contained too much information. The book is hard to navigate and is undoubtedly quite costly. The data in it is required if you are doing in depth sick person billing, but for the littler guy, such as sick person clinics, it is too much info and too difficult to decipher. We receive tons of questions from habitancy who are trying to unblemished a Ub04 form properly.

In order to unblemished the Ub04 forms correctly for facility billing, it is very foremost 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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