Easily Replace Number Fields in the New Patient Information

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A step-by-step guide regarding how to Replace Number Fields in the New Patient Information

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How to Replace Number Fields in the New Patient Information

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What goes in box 38 on a ub04?

38. Responsible Party Name and Address Enter the responsible party name and address.

Where does authorization number go on UB04?

If you are billing on a UB04, the authorization number can also be entered on the patients claim by navigating to Billing Live Claims Feed Inside the patients claim right side of the screen Insurance tab. Authorizations for the patients primary payer (red box) and secondary payer (blue box) can be entered.

What box is DRG in on UB-04?

In addition, for claims that will be reimbursed under the DRG payment methodology: The primary reason for admission should be placed in the primary diagnosis field (Box 67) of the UB-04 claim form.

What codes are used on a UB04 form?

UB-04 Form Locator code lookup FL 4 - Type of Bill. FL 14 - Priority (Type) of Admission/Visit. FL 15 - Point of Origin for Admission or Visit. FL 17 - Patient Status. FL 18-28 - Condition Codes. FL 31-34 - Occurrence Codes. FL 35-36 - Occurrence Span Codes. FL 39-41 - Value Codes.

What is required in box 32 of CMS 1500?

32 Required Service Facility Location Information - Enter the provider name. Enter the provider address, without a comma between the city and state, and a nine-digit zip code, without a hyphen. Enter the telephone number of the facility where services were rendered, if other than home or office.

What is box 71 on a ub04?

71 Prospective Payment System (PPS) Code Not required This code identifies the DRG based on the grouper software and is required only when the provider is under contract with a health plan using DRG codes.

What is a PPS code on a UB04?

LOCATOR 71 PROSPECTIVE PAYMENT SYSTEM (PPS) CODE The PPS code assigned to the claim to identify the DRG based on the grouper.

What is box 15 on ub04?

Box 15 Source of Referral for Admission: (Required if applicable) Indicate the source using the one digit code that represents the source of referral for admission. Required on Hospital claims.

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Replace Number Fields in the New Patient Information