Index

• Sections
  • Setting & Directories Set Up
  • Patient Set Up
  • Creating a UB04 for 837i

UB04 billing (also known as 837i) requires steps to set up in both the patient chart and in the Settings & Directories. This document will outline the setup and submission of UB04 claims. Please be aware that to follow this workflow, your practice does need to have UB04 billing functionality enabled. Please reach out to us for additional details on how to have UB04 billing enabled.  Training is required before UB04 billing can be enabled for your practice. 

Setting & Directories Set Up

1.  From the Chart Room, click the 'Settings & Directories' drawer.  

2.  Click the Group Level Settings & Directories tab and then 'Service/Mod Codes' tab to add your Revenue Codes.

Revenue Codes can be added to the areas outlined in green below.

3.  Room & Board is at the top middle of the Service/Mod Codes Tab. This is an independent Revenue Code.

4.  Set up Revenue Codes. Revenue Codes are only used with UB04 billing. Revenue codes must be added for your practice to use, similar to service codes.

5.  To relate a Revenue Code to a Service Code (HCPCS), add the Revenue Code in the column titled Revenue Code under the Service Code Short List.

6. Click on the 'Insur Payers' tab. 

  a.  A Payer ID will need to be present in the Institutional Payer ID field. this may differ from the Payer ID used for HCFA/Professional claims.

  b.  The Institutional tab allows for changes to the UB04 claim to include or exclude content. These options are set for each payer individually as they may vary from payer to payer.

Patient Set Up

1.  Access your patient's Demographics. These steps will need to be taken for each patient you will be billing UB04 with.

2.  Click on the 'Episode Of Care' tab. Click on the 'From' field to add an admission. Only the most recent episode of care will show on the demographics, but you can click in the field and see all of the episodes of care. 

3.  Add an Admission. This will include several data points listed below.

  a.  Click the '+Add' button to create an EOC. You must click this button to populate b-e

  b.  Click the calendar to select the admission date. 

  c.  Enter the time of admission. 

  d.  Click the calendar to select the discharge date.

  e.  Enter the time of discharge.  

  f.  Click the 'Save' button.

You may want to add the Legal Status of your patient. The options are shown and described below.

PEC---Physician's Emergency Certificate

JC---Judicial Commitment (JC) 

IVC---Involuntary Commitment 

NC---Nonagreed Commitment

FVA--Formal Voluntary Admission 

4.  UB04 billing requires a role for assigned providers in demographics. The attending provider (Att) must be set. Click in the field next to the provider's name to populate a  list to select from.

5. Add the Where Seen location.  

6. Release of Info needs to be entered using the dropdown menu. Click on the field to populate the menu options.

7.  In the Insurance Info tab, address who the responsible party will be. 

If self, check the 'Patient is Responsible Party' box. 

If other than self, go to 'Other Contacts' tab and fill out the guarantor information on the 'Responsible/Guarantor Info' tab. 

8.  Under the 'Insurance Information' tab, select the 'Benefits' tab to complete the 'Assignment of Benefits' box. 

  a. Click in the 'Assign. of Benefits' field.

  b. Select from the options that populate. 

9.  Click on the 'Other Contacts' tab and fill out the Referring Provider Name and NPI (if applicable).

Creating a UB04 for 837i

1.  From the Chart Room, click the EOC/UB04 link on the Patient Accounts drawer.

2.  The Episode of Care tab is split