Sankhani Mtundu wa Ma Bill
Mtundu wamakalata a bili ndi zizindikiro zitatu za malemba omwe ali pa mawonekedwe a UB-04 omwe amafotokoza mtundu wa ndalama zomwe zimaperekedwa ndi wopereka ndalama, monga Medicaid kapena kampani ya inshuwaransi. Code iyi ikufunika pa mzere 4 wa UB-04.
Chiwerengero chilichonse chiri ndi cholinga chenicheni ndipo chimafunikanso kufunsa onse a UB-04 m'munda woyang'anira 4. Tiyeni tifufuze zitsanzo za zikhomo za ndalama ndikuyang'ana chomwe chiwerengero chilichonse chikutanthawuza komanso zizindikiro zikuwoneka bwanji.
Zizindikirozi zimasindikizidwa mu ndondomeko ya National Uniform Billing Committee (NUBC). Fufuzani buku lomwe lilipo panopa kuti musinthe kapena kusintha.
Zitsanzo za mitundu ya Bill
Nazi zitsanzo za mitundu yamakalata a bili ndi zomwe iwo akutanthauza.
- Mtundu wa Bill 111 umaimira Chipatala Chopempha Matenda Achipatala chomwe chimasonyeza kuti nthawi yodzinenera ikuphimba kuvomereza kuperewera kwa wodwalayo.
- Mitundu ya Bill 117 ikuyimira Chipatala cha M'magulu Opita kuchipatala kapena chidziwitso chokonzekera chachipatala chomwe chinaperekedwa kale kuchipatala chomwe chalipira kuti wobwezera athe kubwezera.
- Mtundu wa Bill 138 umayimira Chipatala Chopatsirana Chipatala kapena Chotsutsa cha Chigamulo Choyambirira kwa chilango chomwe chidaikidwa kuchipatala chomwe chinaperekedwa kale chomwe chalipira kuti wobwezera athe kubwezera malipiro opangidwa.
- Mtundu wa Bill 831 umaimira Opaleshoni Yopereka Matenda Achipatala yomwe imachitidwa mu Chipatala Cholandirira Ambulatory. Kuti opaleshoni yachipatala ichitike mu chipatala, mtundu wa ngongole udzakhala 131 mmalo mwa 831.
Choyamba Digit ya Bill Type Code-Type Facility
Chiwerengero choyamba chikuimira mtundu wa malo.
1 - Chipatala
2 - Nursing Aphunzitsi
3 - Home Health
4 - Chipatala chachipatala chosasamalidwa (Chipatala)
5 - Chithandizo cha Zachipatala Chosafunikira Chachipatala (Chisamaliro Chowonjezera)
7 - Chipatala
8 - Chipatala Chapadera, Chipatala cha ASC Chipatala
Second Digit ya Bill Type Code
Chimene chiwerengero chachiwiri chikuyimira kumadalira chiwerengero choyamba. Lili ndi tanthauzo losiyana la ma kliniki ndi malo apadera.
Chiwerengero chachiwiri chimatanthawuza za misonkho kupatula kuzipatala ndi malo apadera.
Ngati chiwerengero choyamba ndi 1-5, ndiye kuti chiwerengero chachiwiri ndi:
1 - Opatsirana ( Medicare Part A )
2 - Opatsirana ( Medicare Part B )
3 - Odwala
4 - Other (Medicare Part B)
5 - Ndondomeko Woyamba Ndondomeko Yanga
6 - Mlingaliro Wachiwiri Wachidule
7 - Kugonana ndi Odwala (pogwiritsa ntchito Revenue Code 019X)
8 - Kutsegula Bedi
Kuzipatala zokha:
Ngati chiwerengero choyamba chiri 7, ndiye chiwerengero chachiwiri ndi:
1 - chipatala chakumidzi
2 - Chipatala Chokhazikitsidwa ndi Chipatala kapena Independent Renal Dialysis
3 - Dongosolo la zaumoyo lovomerezeka ku Federally (FQHC), Free Providing Provided-Based
4 - Malo Otsitsimutsa Ena (ORF)
5 - Malo Operekera Kuchiritsa Odwala (CORF)
6 - Chigawo cha Mental Health (CMHC)
Zomwe Zapadera Zokha:
Ngati chiwerengero choyamba ndi 8, ndiye chiwerengero chachiwiri ndi:
1 - Nonhospital Based Hospice
2 - Chipatala Cholandirira
3 - Mapulogalamu Othandizira Opaleshoni Opita kuchipatala
4 - Malo Otsitsimutsa Ena (ORF)
5 - Malo Operekera Kuchiritsa Odwala (CORF)
6 - Chigawo cha Mental Health (CMHC)
Ndemanga Yachitatu ya Frequency Code-Frequency Code
Nambala yachitatu imatanthawuza kufupipafupi.
0 - Zopanda malipiro kapena Zero Zomvera
1 - Landirani kudzera pa Discharge Claim
2 - Kutenga (Choyamba)
3 - Zamkatimu (Kupitiriza Kuitanidwa)
4 - Zamkatimu (Kutsiriza Kwambiri)
5 - Chakudya Chakumapeto Kokha
7 - Kubwezeredwa kwa Chidziwitso Choyambirira kapena Chidziwitso Chokonzedwa
8 - Kuwoneka kapena Kuletsedwa kwa Chidziwitso Choyambirira
9 - Zotsiriza Zomwe Zidzakhala Pakhomo Pachasite PPS
Mitundu ya Maofesi Pogwiritsa ntchito UB-04
Maofesi omwe amagwiritsa ntchito mawonekedwe a UB-04 ndi awa:
- Chigawo cha umoyo waumphawi
- Malo Othandizira Kwambiri Othandizira Kukhalitsa
- Chipatala Cholandirira
- Malo Otha Kudwalitsa Matenda a Matenda Odzipha
- Gulu Lathanzi Logwirizana ndi Federally
- Histocompatibility Laboratory
- Home Health Agency
- Hospice
- Chipatala
- India Health Services Facility
- Organisation Organisation Organisation
- Odwala Opaleshoni Yophatikiza Thupi
- Ntchito zachipatala zogwira ntchito
- Ntchito Zothandizira Odwala
- Chipembedzo chachipatala chopanda mankhwala
- Mchipatala chakumidzi
- Chidziwitso cha Nursing
Malingaliro Okonzedwa
Pamene mukupanga kusintha kuzinthu zowonongedwa kale, zowonongeka zambiri zingatumizedwe pakompyuta.
1. Bweretsani Claim Frequency Code ndi: 7 = Kusintha kwa chigamulo choyambirira 8 = Kutsegula / kutsegula kwa chiyeso choyambirira
2. Lembani chigamulocho pogwiritsa ntchito DCN (chiwerengero cholembera chilemba) kapena ICN (chiwerengero choyendetsa) kuchokera ku malingaliro a kulipira (EOP) kapena kubweza kwa magetsi .
3. Ngati mukuyenera kutumiza mapepala ovomerezeka, onetsetsani kuti fomuyo ndi yolondola. Ena amalipira amavomereza zojambula zakuda ndi zoyera zazitsulo zachipatala koma njira yabwino kwambiri ndi kuperekera vesi loyambirira-lofiira ndi loyera. Malinga ndi wolipira, pamene mawonekedwe oyambirirawo sakugwiritsidwa ntchito, malingalirowo sangapangire mu dongosolo lawo bwino kulenga kuchedwa kapena kukana kulipira.
Mfundo zofunika pakukwaniritsa zonena izi zikuphatikizapo:
- Onetsetsani kuti printeryo yayikidwa bwino kuti atsimikizire kuti nkhaniyi imasindikizidwa kumalo oyenera.
- Musati muwonetsetse chidziwitso chirichonse pa zomwe akunenazo.
- Musalembedwe ndemanga pa mawonekedwe monga "Corrected Claim" kapena "EOB Attached."
- Musagwirizane zofunikira, masampampu, matepi, ndodo zomata, mapepala a papepala kapena china chilichonse ku mafomu omwe akufuna.
Mfundo Yofunika pa Ma Bill A Bill kwa Fomu ya Claim UB-04
Zomwe zili pamwambazi zikufotokozera cholinga chenicheni cha manambala atatu pa bukhu la UB-04. Zomwezi zikhoza kusintha ndi kusintha, koma kusintha kulikonse kungapezeke mu ndondomeko ya National Uniform Billing Committee (NUBC).
Zizindikirozi zimasindikizidwa mu ndondomeko ya National Uniform Billing Committee (NUBC). Fufuzani buku lomwe lilipo panopa kuti musinthe kapena kusintha.
> Chitsime:
> Komiti Yoyendetsa Bungwe la National Uniform Billing Committee. Buku lotsogolera UB-04 Bukuli 2016. http://www.nubc.org/subscriber/PDFs/UB042016TOC.pdf