Hlela Uhlobo Lwemiyalo Yomthethosivivinywa
Uhlobo lwamakhodi wesikweletu luyikhodi yamadijithali amathathu atholakala ku-UB-04 ifomu lokumangalela elichaza uhlobo lunivivinywa umhlinzeki ohambisa umkhokhi, njengeMedicaid noma inkampani yomshuwalense. Le khodi iyadingeka kulayini 4 we-UB-04.
Idijithi ngayinye inezinhloso ezithile futhi iyadingeka kuzo zonke izimangalo ze-UB-04 endlebeni yensimu 4. Ake sihlole ezinye izibonelo zamakhodi wesikweletu bese sibheka ukuthi iyiphi idijithi ngayinye echaza nokuthi yimaphi amakhodi abukeka.
Amakhodi ashicilelwe ku-National Uniform Billing Committee (NUBC) imihlahlandlela. Hlola ibhuku lamanje nganoma yiziphi izinguquko noma izibuyekezo.
Izibonelo zezinhlobo zeBill
Nazi izibonelo zezinhlobo zamakhodi we-bill kanye nalokho okushoyo.
- Uhlobo lomthethosivivinywa 111 lumele isimangalo sesibhedlela esibhedlela esibonisa ukuthi isikhathi sesimangalo sihlanganisa ukuvuma kokuphuma kwesiguli.
- Uhlobo loMthethosivivinywa 117 lumele ukufaka esikhundleni se-Hospital Inpatient Replacement noma isimangalo esilungisiwe sesimangalo esibhedlela esibhedlela esithunyelwe ngaphambilini esibhalisiwe ukuze umkhokheli akhokhele isimangalo.
- Uhlobo lomthethosivivinywa 138 lusemvume yokuphulukisa izibhedlela noma ikhansela lokumangalelwa kokuqala kwesibango sesibhedlela esibanjwe ngaphambili esikhokhelwe ukuze umkhokheli akhokhe kabusha inkokhelo eyenziwe.
- Uhlobo Lomthethosivivinywa 831 lumele ukwelashwa kweziguli ezibangelwa izibhedlela ezenziwa esikhungweni sokuhlinzeka ngeziguli. Ukuhlinzwa okwelashwa okwenziwa esibhedlela, uhlobo lwe-bill luzoba ngu-131 esikhundleni se-831.
I-Digit yokuqala yohlobo lweBill Type Code-Type Facility
Idijithi yokuqala ibhekisela kuhlobo lendawo.
1 - Isibhedlela
Ubuhlengikazi abanekhono
3 - Impilo Yasekhaya
4 - Isikhungo Sokunakekelwa Kwezempilo Ezingekho Emphakathini (Isibhedlela)
5 - Insizakalo Yokunakekelwa Kwezempilo Ezingekho Emphakathini (Ukunakekelwa Okunwetshiwe)
I-7 - Ikliniki
8 - Isikhungo Esikhethekile, Isibhedlela Se-ASC
I-Digit yesibili ye-Bill Type Code
Okushiwo yidijithi yesibili kuncike kudijithi yokuqala. Unesethi ehlukile yezincazelo zemitholampilo nezakhiwo ezikhethekile.
Idijithi yesibili ibhekisela kuhlelo lokukhokha ngaphandle kwemitholampilo kanye nezikhungo ezikhethekile.
Uma idijithi yokuqala ingu-1-5, idijithi yesibili yilezi:
1 - Isiguli ( Medicare Part A )
2 - Isiguli ( Medicare Part B )
3 - Isiguli
4 - Okunye (Medicare Part B)
5 - Level I Care Intermediate
6 - Level II Ukunakekelwa Okuphakathi
I-7 - I-Subacute Isiguli (sokusetshenziswa neRevenue Code 019X)
8 - Umbhede Wama-Swing
Emitholampilo kuphela:
Uma idijithi yokuqala ingu-7, idijithi yesibili yile:
1 - Umtholampilo Wezempilo Emaphandleni
2 - Isikhungo se-Dialysis esisekelwe esibhedlela noma esizimele
3 - Isikhungo Sempilo Esifanelekayo se-Federally (FQHC), Isihlinzeko Esisekelwe Esimeni Esikhululekile
4 - Okunye Isikhungo Sokuvuselela (ORF)
5 - Isikhungo Sokuvuselela Ukuphulukiswa Kwangaphandle (CORF)
6 - Isikhungo sezempilo seMental Community (CMHC)
Izidingo ezikhethekile kuphela:
Uma idijithi yokuqala ingu-8, idijithi yesibili yilezi:
1 - I-Hospitally Based Hospice
2 - Isibhedlela esisekelwe esibhedlela
3 - Amasevisi Okuhlinzeka Ngesivinini Sokuhlinzekela Iziguli Ezibhedlela
4 - Okunye Isikhungo Sokuvuselela (ORF)
5 - Isikhungo Sokuvuselela Ukuphulukiswa Kwangaphandle (CORF)
6 - Isikhungo sezempilo seMental Community (CMHC)
I-Digit yesithathu yohlobo lweBill Code Code-Frequency
Idijithi yesithathu ibhekisela kumvamisa.
0 - Ukungakhokhi imali noma Izimangalo Zero
1 - Thumela ngokuKhipha isimangalo
2 - Isikhathi (Isikhathi sokuqala)
3 - Isikhathi esincane (Izimangalo eziqhubekayo)
4 - Isikhathi esincane (Isikhathi sokugcina)
5 - Ukukhokhiswa Kwesikhashana kuphela
7 - Ukufaka isicelo seSimangalo esandulele noma isimangalo sokulungiswa
8 - Kungavumelekile noma Khansela Ngaphambi Kokumangalelwa Okungaphambili
9 - Isimali sokugcina se-PPS ye-Home Health episode
Izinhlobo zezinsiza Ukusebenzisa i-UB-04
Izinsiza ezisebenzisa ifomu le-UB-04 zifaka:
- Isikhungo sezempilo somphakathi
- Isikhungo sokuPhepha okuPhezulu okuPhezulu okuPhezulu
- Isibhedlela sokufinyelela esibucayi
- Isikhungo sokugcina isifo sokuqeda izifo
- Isikhungo sezeMpilo esifanelekayo seFederalally
- I-Histocompatibility Laboratory
- I-Health Health Agency
- Izibhedlela
- Isibhedlela
- I-Indian Health Services Facility
- Inhlangano Yokuthenga Impahla
- Imisebenzi yokwelapha yangaphandle yokuphulukisa umzimba
- Izinsizakalo Zezokwelapha Emsebenzini
- Izinsizakalo zokuHlelwa kweziNkulumo
- Isikhungo Sokunakekela Impilo Engekho Ezokwelapha
- Umtholampilo Wezempilo Emaphandleni
- Isikhungo sosizo lwezokwelapha
Izimangalo ezilungisiwe
Uma wenza izinguquko kumangalo akhokhelwa ngaphambilini, izimangalo eziningi ezilungisiwe zingathunyelwa ngekhompyutha.
1. Buyekeza ikhodi yeFrequency Frequency nge: 7 = Ukufaka esikhundleni sesimangalo sokuqala 8 = Ukungena / ukukhansela kwesimangalo esandulele
2. Hambisa isimangalo usebenzisa i-DCN (inombolo yokulawulwa kwedokhumenti) noma i-ICN (inombolo yangaphakathi yokulawula) ngokuchazwa kwenkokhelo yokukhokha (EOP) noma ukukhishwa kwe- electronic .
3. Uma kufanele uthumele isimangalo esilungisiwe ephepheni, qiniseka ukuthi ifomethi ilungile. Abanye abakhokha bamukela izinguquko ezimnyama nezamhlophe ezifakwe emaphoyiseni, kodwa inqubo engcono kakhulu ukuhambisa inguqulo yokuqala ebomvu neyomhlophe. Kuye okhokhayo, lapho ifomu lokufaka isicelo sokuqala lingasetshenzisiwe, isimangalo singase singene kwisistimu yaso ngokudala ukubambezeleka noma ukuphika inkokhelo.
Amaphuzu abalulekile ekuqedeni lezi zimangalo zihlanganisa:
- Qiniseka ukuthi iphrinta ifakwe kahle ukuze kuqinisekiswe ukuthi ulwazi lunyatheliswa ezindaweni ezifanele zendawo.
- Ungagcizelela noma yiluphi ulwazi mayelana nesimangalo.
- Ungabhale phansi imibono efomu efana ne-"Claim Claim" noma "EOB Ehlanganisiwe."
- Ungamathisi ama-staples, izitembu, amatheyipu, amanothi anamathele, isiqeshana sephepha noma yini enye emafomu amangalo.
Ngezansi kumakhodi omthetho weBill kuFomu yeSimangalo se-UB-04
Ulwazi olungenhla luchaza injongo yamanje yamanani ama-3 ngayinye kwifomu yezimangalo ze-UB-04. Lolu lwazi luzoshintsha futhi lubuyekezwe, kodwa noma yiziphi izinguquko zingatholakala ku-National Uniform Billing Committee (NUBC).
Amakhodi ashicilelwe ku-National Uniform Billing Committee (NUBC) imihlahlandlela. Hlola ibhuku lamanje nganoma yiziphi izinguquko noma izibuyekezo.
> Umthombo:
> Ikomidi lokuThengisa iNational Uniform. Incwadi esemthethweni ye-UB-04 Inombolo Yokucaciswa Kwedatha 2016. http://www.nubc.org/subscriber/PDFs/UB042016TOC.pdf