Update Bill-Type Prefix

Use this rule to update the bill-type prefix for a claim without changing the billing profile.

Workflow

Let's review how to create a claim rule that updates the bill-type prefix on a claim!

1. Navigate to Management Center > Claim Rules.
   
    
2. Then click Create Service Grouping Rule.
   
3. Select the Practice.
   
4. Next, give the rule a name.
   
5. Adjust the order when applicable and select the service from the Service drop-down.
6. Select Conditions to create criteria that a claim should meet before the rule will apply.
   
7. Next, under Set Values, click Set Bill-Type Prefix to:.
8. Enter the desired Bill-Type Prefix.
   
9. Finally, click Save to complete the process.
    

Box Number(s)

• UB-04: Box 4 - Type of Bill
• 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.