Claim Form Rule - Change Bill Type Suffix to 0 For Nonpayable

  • Updated

To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.

To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article. 

What claim change is needed?

Update the claim bill type suffix on the UB-04 claim form to 0 for non-payable.

Note: Bill types are managed automatically by default based on admit and discharge date for the patient. If changes need to be made to override the default settings, a claim form rule will be needed.

Default bill types for a date of service are as follows:

  • Bill Type Suffix 2 - Admit Date
  • Bill Type Suffix 3 - Any date between admit and discharge
  • Bill Type Suffix 4 - Discharge Date

Box Number

UB-04: Box 4

CMS-1500: N/A

Steps

  1. Navigate to Management Center > Claim Rules.
  2. Click "Create Claim Form Rule".
  3. Select the practice.
    mceclip2.png
  4. Name the claim rule.mceclip0.png
  5. Set Claim Type to Institutional.
    mceclip1.png
  6. Set conditions for the claim rule to meet.
  7. Under Available Behaviors, select Bill-Type Suffix.mceclip1.png
  8. Click add
  9. Select "0 - Non-Payable" in the dropdownmceclip2.png
  10. Save

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