Add or Remove Patient Admit Hour

This rule adds or removes the patient's Admit Hour from the claim. 

Workflow

Let's review how to create a claim rule to manage the patient's admit hour!

• 1. 1. Navigate to Management Center > Claim Rules.
        
        
     2. Click Create Claim Form  Rule.
        
     3. Select the Practice.
        
     4. Next, give the rule a name.
     5. Update the Claim Type to Institutional.
        
     6. Select Conditions to create criteria a claim should meet before the rule will apply.
        
     7. Next, click on the Behaviors dropdown.
     8. Select Patient - Admit Hour.
        
     9. Next, click Add.
        
     10. Update the dropdown to one of the following:
         1. Omit remove the Admit Hour from the claim.
         2. Write to Claim to include the Admit Hour in the claim.
            
     11. To create multiple behaviors, repeat steps 7-10.
     12. Click Save to complete the process.
          

Box Number(s)

• UB-04: Box 13 - Admission Hour
• CMS-1500: N/A

Helpful Hints

• If one of your conditions is payer-based, select Current Sequence Behavioral instead of the Primary Behavioral Payer. This will ensure the rule applies to secondary and tertiary claims when needed. 
• 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.