Box 4 - Type of Bill

  • Updated

Box Definition

Box 4 on the UB-04 claim form is intended to display the type of bill to the payer for claim processing.

In AveaOffice

Let's review how to update the Second and Third digit of the Bill Type also known as the Bill Type Prefix on Institutional Claims.

  1. Navigate to Practice Admin > Service and select the Service you wish to update.
  2. Within the Service Profile, select the Billing Profiles subtab to display Billing Profiles associated with the Service.
    1. Tip: To see what Billing Profile was used during the Claim Creation, navigate to the Patient Profile > Treatment Episode > UR > Attendance History.
  3. To update some claims based on Date of Service, select the Create Scheduled Change Set icon and set the Effective Date.
  4. Once you have selected an Effective Date, select Save and allow the system to refresh
  5. Locate and select the Pencil icon next to the Scheduled Change Set.
  6. In the Edit window, update the Institutional Bill Type Prefix and scroll to the bottom to Save. 
  7. To update all Claims submitted with the existing bill type, select the Pencil icon at the Baseline and repeat the process from Step 4. 
  8. Follow the Corrections process to update the affected claims.

Updating Bill Type suffixes.

Let's review how the system determines the Bill Type suffix and how to update it.

    • Suffix 1 indicates the Dates of Service on the Claim encompass the entirety of the patient stay known as Admit-through-Discharge.
    • Suffix 2/3/4 indicates the claim is the Interim-:First Claim, Continuing Claim, or Last Claim.
    • Suffix 7 indicates the claim is a resubmission with updated information (i.e. a Correction.) 
    • Suffix 8 indicates the claim is now Voided.
  1. To update the Suffix to 1, 2, 3, or 4, navigate to the Management Center > Claim Rules and select Create Claim Form Rule
  2. Select the Conditions a claim needs to meet before the rule can be applied.
  3. Under Behaviors, select Bill-Type Suffix then Add.
  4. In the dropdown, select the suffix to apply to the claim then scroll down and select Create
  5. Since the system will not generate corrections that only affect the suffix, the correction will need to be generated within the Patient Profile. 
  6. Navigate to the Patient Profile  > Treatment Episode > Insurance Billing > Claims and select Resubmit.
  7. In the Create Claim Resubmission Window, toggle the Submit as New Claim switch to tell the system to update the Bill Type Suffix and bypass the Internalized Control Number requirement.
  8. After selecting the Resubmission Issue, select Create to create the resubmission.
  9. To confirm the rule applied as desired, navigate to Work Center > Insurance Claims > Submit Claims and select View to confirm the correct Bill Type Suffix applied before select Submit.
  • Note: AveaOffice does not currently support Admit-through Discharge claims with more than 1 Authorization number. Please reach out to the for additional assistance.

EDI Loop/Segment

Loop 2300, Segment CLM05-1 & CLM05-3


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