sickness billing format

Get the free sickness billing format

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Tonight, we have Dawn. Now, if you’ve been on some of our past webinars, you may have met Dawn. Alicia: There she is. Boyd: Taadaa! Dawn: Hey, how are you? Boyd: We’re doing great, how are you? Dawn: Hangin’ in there. Boyd: You’re still alive and well, great. Thanks for joining us here tonight. Dawn: Cool! Alicia: Dawn is our billing course instructor. It’s an intense but fun course. Dawn likes to make it kind of light but there’s a lot of information going on in the textbook that we have. We had a question come in to the forum that it was perfect for Dawn, so we had it come in tonight regarding the 1500 forms versus the UB 04 forms. This ASCs stands for ambulatory surgery centers, if you didn’t know. Q: The question is, Dawn: Do ASCs use the CMS 1500 or UB 04 forms? Here’s a picture of both of those… Dawn: A: Actually, Alicia, that’s a really good question. It’s actually a question that I once had. If you don’t do ambulatory surgery coding, it’s not something that you would just naturally know. What all medical billing students are taught is that inpatient billing is done on the UB 04 and outpatient billing is done on the CMS 1500 form. So, an ambulatory surgery centers kind of in between both of them, so what do you use? The answer is both forms are used depending on what type of ASC you’re billing for. If the surgery center is part of the hospital, you’re probably going to use the UB 04 form because hospitals use that form. They keep everything standardized, it’s part of the hospital, they’ll bill on the UB 04 form. If it’s a freestanding ambulatory surgery center not associated with the hospital, it will probably bill out using the CMS 1500 form as to the outpatient facility would. The main difference between the UB 04 form and the CMS 1500 form is the CMS 1500 is basically has less stuff on it, like less spaces for stuff, because when we go to the doctor and you have an encounter there’s only so many things that’s going to happen in that kind of a setting. Whereas, when you’re in the hospital they’re scanning everything. They bring you a Q-tip, they’re going to scan that thing in for $10 now on your chart; so you need a lot more spaces for everything. That’s why the UB 04 inpatient is much more complex than the CMS 1500 form. So, basically, my long-winded answer is, if it’s a freestanding ambulatory surgery center it will go on the CMS 1500. If it’s part of the hospital, it will be billed on the UB 04. Also, I wanted to mention about the medical billing course that I’m a coach or instructor for. I really like this course and the reason is we have the textbook component, which is the best textbook in the industry. It’s the same one the AAPC uses, so I’m expecting that our students will have absolutely no problem passing the board exam. We didn’t put a bunch of fluff in the course where students are doing tons and tons and tons of busy work. Adult students want to get into a course and they want to get out of the course and they want to get a...
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