UB-92


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UB-92

HCFA 1450, Uniform/Universal Billing form 92 Managed care The official HCFA/CMS form used by hospitals and health care centers when submitting bills to Medicare and 3rd-party payors for reimbursement for health services provided to Pts covered. See Compliance. Cf HCFA 1500.

CMS-1450

The uniform institutional health care insurance claim form in the U.S. Previously known as the HCFA-1450 claim form or UB-92.
Synonym(s): HCFA-1450, UB-92.
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Some states, such as New York and California, have expanded the standard UB-92 to include an indication of whether or not each secondary diagnosis is present at admission.
In anticipation of post-payment review, SNFs must initiate a system of checks and balances designed to detect and prevent UB-92 and MDS errors.
In all, more than 30 states began collecting UB-92 data on inpatients, but what they did with those data, and how they risk-adjusted the outcomes (length of stay, charges, and mortality rates) defined by those data varied widely from state to state.
SLMC is now processing an average of 5,000 paper claims per day and reading about 450 to 500 characters per form on HCFAs, and about 600 to 700 on UB-92s.
California and New York require hospitals to report on inpatient admissions using the standard UB-92 data set but risk-adjust those data by proprietary methodologies developed by each state.
ClaimTrack is a Windows-based claims management system that provides online edits, error correction and processing for UB-92 and HCFA-1500 claims.
Used by health care providers required to submit UB-92 data, DataBay Check is a data editor that allows the user to validate and edit discharge data for accuracy and transmits utilization data electronically to state agencies.
For billing purposes, the 15-minute increments may be used on the UB-92 claim form, since the RUG score is calculated from the MDS and not from the bill.
They also can be used to capture HCFA 1500 and UB-92 health claims and unstructured documents such as invoices, freight bills and Explanations of Benefits.
The biller must then decipher pertinent data and enter it onto the UB-92, translating the "reason for assessment" (MDS section AA8a,b) into one of 19 allowable modifier codes and assigning the correct number of covered days to each MDS applicable to a calendar month.
The DMC Physician Group uses The Per-Se Exchange for online editing, error correction and processing, as well as print and mail services to speed patient collections, creating one solution for UB-92 and HCFA-1500 outputs.