Misela uhlobo lweeNcwadi zeBill
Iikhowudi zeefowuni zikhowudi zeefayile ezi-3 zifumaneka kwifom yesicelo seBB-04 echaza uhlobo lomrhumo umniki-mali unika umhlawuli-mali, njengeMedicaid okanye inkampani yomshuwalense. Le khowudi iyadingeka kumgca 4 we-UB-04.
Idijithi nganye inenjongo ethile kwaye iyadingeka kuwo onke amabango e -UB-04 kwindawo yokufumana indawo 4. Makhe sihlolisise imimiselo yeefowuni zebhilikhi uze ubhekisise ukuba yeyiphi idijithi nganye kunye nendlela ebonakala ngathi.
Iikhowudi zishicilelwe kwiKomiti yeSizwe yoTyala lokuThengisa iNational Uniform (NUBC). Khangela incwadana yangoku naluphi na utshintsho okanye uhlaziyo.
Imizekelo yeeNtlu zeBill
Nazi imimiselo yeentlobo zeekhowudi zebhilikhi kunye noko bathethayo.
- Uhlobo lweBill 111 lubonisa ukuba iSibhedlele soMatyala esibhedlele esibonisa ukuba ixesha lebango libandakanya ukuvuma ukukhutshwa komguli.
- Uhlobo loYilwayo 117 lumela iNdawo yokuTshintshwa kweZibhedlele zeZibhedlele okanye ibango elichanekileyo kwisibhedlele esibhedlele esibhedlele esibanjwe kwangaphambili ukuba ihlawulwe ukwenzela ukuba umhlawuli ahlawule ibango.
- Uhlobo lweBhilidi 138 lubonisa iVital Outpatient Void okanye I-Cancel yesibango esingaphambi kwesibango sesibhedlele esithunyelwe kwangaphambili esibhalisiweyo ukwenzela ukuba umhlawuli aphinde ahlawule intlawulo eyenziweyo.
- Uluhlu lweBill 831 lubonisa ukuPiliswa koPhulo lweZibhedlele esibhedlele kwiCandelo lokuPhepha lokuThengisa. Ukuba unyango lwabagulayo lwenziwa esibhedlele, uhlobo lwebhilikhi luya kuba ngu-131 endaweni ye-831.
I-Digit yokuqala yoLuhlu lweBhili yoLuhlu-uhlobo loNcedo
Idijithi yokuqala ibhekisela kuhlobo lwesibonelelo.
1 - Isibhedlele
2 - Abanobuchule abanesiqinisekiso
3 - Impilo Yasekhaya
4 - Isibonelelo seNkonzo yezeMpilo engeNyango (iSibhedlele)
5 - Iinkonzo zeNkonzo zeMpilo ezingekho phantsi kweMveli (Uncedo oluNyelweyo)
7 - Iikliniki
8 - I-Specialty Facility, Isibhedlele se-ASC
I-Digit yesiBini yoLuhlu lweBhili
Oko idilesi yesibini ibonakalisa kuxhomekeke kwidijithi yokuqala. Iineentlobo ezahlukeneyo zentsingiselo zeeklinikhi kunye nezibonelelo ezizodwa.
Idijithi yesibini ibhekisela kwisigaba sobhengezo ngaphandle kweeklinikhi kunye nezibonelelo ezizodwa.
Ukuba idijithali yokuqala ngu-1-5, ke idijithi yesibili yile:
1 - Isigulane (i- Medicare Part A )
2 - Inpatient ( Medicare Part B )
3 - Isigulane
4 - Okunye (Medicare Part B)
5 - Inqanaba leNkcazo yoNyaka phakathi
6 - Inqanaba II Uncedo oluphakathi
I-7-Subacute Isigulane (sokusetyenziswa kunye neNgeniso ye-Revenue Code 019X)
8 - Ibhedi Yokuguqa
Kwiiklinikhi kuphela:
Ukuba idijithali yokuqala i-7, ke idijithi yesibili yiyo:
1 - Ikliniki yezempilo yasemaphandleni
2 - iSibonelelo seSibhedlele esisisiseko okanye esizimeleyo seDial Dialysis
I-3 - iZiko lezeMpilo eliLungeleleneyo lezeMpilo (i-FQHC), uMboneleli oMiNtando oMahla
I-4 - Ezinye izibonelelo zokuXhobisa (ORF)
5 - Isibonelelo sokuPhepha okuPhezulu esiPheleleyo (CORF)
6 - Iziko lezeMpilo yengqondo (Community CMHC)
Izixhobo eziZodwa kuphela:
Ukuba idijithi yokuqala iyisi-8, idijithi yesibili yile:
1 - I-Hospitality Based Hospice
2 - Isibhedlele esisisigxina
I-3 - IiNkonzo zeZiko lokuPhepha zokuVikela kwiZibhedlele zeZibhedlele
I-4 - Ezinye izibonelelo zokuXhobisa (ORF)
5 - Isibonelelo sokuPhepha okuPhezulu esiPheleleyo (CORF)
6 - Iziko lezeMpilo yengqondo (Community CMHC)
I-Digit yesiThathu yeBhili yoLawulo lweBhodi yoLwazi-Frequency
Idijithi yesithathu ibhekisela kwixesha.
0 - Ukuhlawulwa kweerhafu okanye ii-Zero zamangalo
1 - Yamkela ngokuKhutshwa kweMali
2 - iTyimari (Ibango lokuqala)
3 - Iimviwo (Iimangalo eziqhubekayo)
I-4 - iTyimari (Ibango lokugqibela)
5 - Ukuhlawulwa kwexesha kuphela
7 - Ukutshintshwa kweBango eliPhambi okanye iBango eliLungisiweyo
8 - Ukukhutshwa okanye ukuChoxiswa kweBango eliPhambi
9 - Ibango lokugqibela kwi-PPS yempilo yePPS
Iintlobo zezixhobo Ukusebenzisa i-UB-04
Izixhobo ezisebenzisa ifom yeBB-04 ibandakanya:
- Iziko Lempilo Yengqondo Yomphakathi
- Isibonelelo sokuPhepha okuPhezulu ngokuPhezulu
- Isibhedlele esiPhakathi
- IsiGesi sokuThatyelwa kweeNtsholongwane
- Iziko lezeMpilo eliLungeleleneyo lezeMpilo
- ILebhanti ye-Histocompatibility
- KwiKhaya lezeMpilo
- Hospice
- Isibhedlele
- IiNkonzo zeMpilo zeNdiya
- Umbutho woThengiselo lweMpahla
- IziPhulo zoPhulo lweMpilo
- IiNkonzo zonyango
- Iinkonzo zeNtlupheko zeNtetho
- Iinkonzo zeZonyango ezingekho phantsi kwezeMpilo
- Iiklinikhi zeMpilo yasemaphandleni
- Indawo yokuLondolozwa kwabasebenzi
Amabango afanelekileyo
Xa wenza utshintsho kwiibango zangaphambili ezihlawulwe, amanqaku amaninzi achanekileyo angathunyelwa ngekhompyutha.
1. Hlaziya i-Code Frequency Code nge: 7 = Ukutshintshwa kwesibango sokuqala 8 = Ukungabikho / ukuchithwa kwebango langaphambili
2. Hambisa ibango usebenzisa i-DCN (inombolo yolawulo lwencwadi) okanye i-ICN (inombolo yangaphakathi yokulawula) kwingcaciso yomhlawuli wentlawulo (i-EOP) okanye ukukhishwa kwe- elektroniki .
3. Ukuba kufuneka ungenise ibango elichanekileyo kwiphepha, qiniseka ukuba ifomathi ilungile. Abanye abakhokheli bamkela iinguqu ezimnyama-kunye ezimhlophe zenguqu zamabango ezonyango kodwa inkqubo efanelekileyo kukungenisa ingqungquthela yokuqala ebomvu neyemhlophe. Ngokuxhomekeke kumbahlawuli, xa ifom yesibango sokuqala ayisetyenzisiweyo, ibango alikwazi ukukhangela kwinkqubo yabo ngokufanelekileyo ukudala ukulibazisa okanye ukuphika intlawulo.
Amaphuzu abalulekileyo ekuzaliseni la mabango afaka:
- Qinisekisa ukuba umshicileli ulungiswe ngokufanelekileyo ukuqinisekisa ukuba ulwazi lushicilelwe kwiindawo ezifanelekileyo zentsimi.
- Ungagxininisi naziphi na iinkcukacha kwibango.
- Musa ukubhala phantsi izimvo kwifom efana ne "Iimangalo ezilungisiweyo" okanye "I-EOB edibeneyo."
- Ungamathinteli izicwangciso, izitampu, iteksi, amanqaku enamathenda, iphepha lephepha okanye nayiphi na into kwiifomu zamabango.
Ngaphantsi kweeNcwadi zeBill kwiFomu yeBango le-UB-04
Ingcaciso engentla ichaza injongo yangoku yeenombolo ezi-3 kwifomu yebango le-UB-04. Olu lwazi luya kutshintshwa kwaye luhlaziywe, kodwa nayiphi na inguqu inokufunyanwa kwiKomiti yeSizwe yoTyala lokuTyala (iNUBC).
Iikhowudi zishicilelwe kwiKomiti yeSizwe yoTyala lokuThengisa iNational Uniform (NUBC). Khangela incwadana yangoku naluphi na utshintsho okanye uhlaziyo.
> Umthombo:
> IKomiti yeSizwe yoTywala eFanayo. Umqulu we-UB-04 weNgcaciso yeMininingwane 2016. http://www.nubc.org/subscriber/PDFs/UB042016TOC.pdf