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Replace SNN Field from the Accident Medical Claim Form

Replace SNN Field from the Accident Medical Claim Form

Aug 6th, 2022

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How to Replace SNN Field from the Accident Medical Claim Form

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In this video tutorial, the presenter explains how to complete a HICFA 1500 claim form, which is used by non-institutional healthcare providers to submit claims. Although most claims are submitted electronically, secondary claims may be submitted on paper using the primary Explanation of Benefits (EOB). The tutorial provides a step-by-step process, starting with selecting "Other" in Box 1 for commercial insurance and entering the member ID. Box 2 requires the patient's name, while Box 3 includes the patient's date of birth and gender. Box 5 is for the patient's address and phone number, and Box 6 indicates the patient’s relationship (in this case, self). The presenter emphasizes filling out the patient’s information, unless there is a different policyholder.

Got questions?

Below are some common questions from our customers that may provide you with the answer you're looking for. If you can't find an answer to your question, please don't hesitate to reach out to us.

What is Box 39 on UB04?

Box 39-41; a-d Value codes and amounts: (Optional) Use these locators to indicate codes and amounts essential to the proper adjudication of the submitted claim. Each form locator contains a three digit field in which to key the indicator code, and a larger free text field in which to designate an applicable amount.

What box are value codes on UB04?

They can be easily added to the UB04 by navigating to Billing Live Claims Feed Inside patients encounter right side of the screen value code tab. The codes entered here (up to 4 for each box) will appear on the UB04 in boxes 39-41.

What is the field 9 in CMS 1500 claim form?

9. Name of the INSURED PERSON of other payer in Insurance Information screen under Patient Master.

What goes in box 38 on a UB04?

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

What is box 37 on UB04?

37 Reserved for Assignment by the NUBC Not Required N/A 38 Responsible Party Name and Address Not required N/A 3941 Value Codes and Amounts Situational These fields contain the codes and related dollar amounts to identify the monetary data for processing claims.

What are the four sections of the UB-04?

Section 1: Credentialing. Section 2: Contracting. Section 3: Hospital Inpatient Notifications. Section 4: Transfer of Patients to/from Facilities. Section 5: Hospital Bill Audits. Section 6: UB-04 (CMS 1450) Guidelines. Section 7: Interim Bills and Late Charges. Section 8: Sample UB-04 (CMS 1450) Claim Form. Section 9:

What is field 23 in CMS 1500 claim form?

Box 23 is used to show the payer assigned number authorizing the service(s).

What is field 24 in CMS 1500 claim form?

A Place of Service (POS) is a field used when completing a CMS 1500 form to submit a claim to insurance. It indicates the location in which the health care service is actually provided.

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