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Replace SNN Field to the Accident Medical Claim Form

Replace SNN Field to the Accident Medical Claim Form

Aug 6th, 2022

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How to Replace SNN Field to the Accident Medical Claim Form

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In the video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers for submitting claims. While most claims are submitted electronically, secondary claims require paper submission with the primary Explanation of Benefits (EOB). The tutorial walks through filling out the form, starting with selecting "other" under the type of insurance for a commercial policy in box 1, followed by entering the member ID. It continues with the patient's name (box 2), date of birth and gender (box 3), address and phone number (box 5), and patient relationship (box 6), indicating "self" in this case. Finally, the presenter addresses box E regarding any other health benefit plans relevant to the claim.

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 field 17 on a UB04?

17 Patient Status Required. This code indicates the patients status as of the Through date of the billing period (Field 6). 18-28 Condition Codes Leave blank.

What is field 14 on UB 04?

Box 14 of the UB04 claim form requires a description of the type of admission. You can quickly add this information via the patients encounter under your Live Claims Feed. Navigate to Billing Live Claims Feed Inside the patients encounter right side of the screen info tab.

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.

What are the fields of UB-04?

You may be wondering, What does UB-04 mean? Simply put, this form can be used by any institutional provider for billing medical and mental health claims. This uniform billing form was created by The Centers for Medicare and Medicaid (CMS) to be used by institutional providers for claim billing.

What is FL 14 priority type of admission or visit?

FL 14 - Type of Admission/Visit Required on inpatient bills only. This is the code indicating priority of this admission. Code Structure: 1 Emergency - The patient required immediate medical intervention as a result of severe, life threatening or potentially disabling conditions.

What is box 15 on a UB04?

Box 15 - What is a Point of Origin Code and how do I include it on an institutional claim? A point of origin code discloses to the payer the source or method of the patients referral for admission. The point of origin code is similar to a place of service code on a professional claim/HCFA-1500 form.

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 the field 9 in CMS 1500 claim form?

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

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