Author Topic: Billing service units  (Read 931 times)

missy1katie2

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Billing service units
« on: December 15, 2008, 03:05:32 PM »
I have a home care company and I provide an LVN in the home from 7a-7p seven days a week.  I also provide a CNA in the home for this patient from 7p-7a.  I also provide 2 hours a month of Social Work for this case.  How do I do I calculate service units for Box 46 of UB04 since I bill and pay for 12 hours at a stretch.  Do I multiple service units by 4 since 4 units equal 53 minutes. Help- don't have a clue- billing on a UB 04 or any kind of billing for insurance- completely need to me.  Your workbook helped a lot, still have unanswered questions. Thanks

Michele

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Re: Billing service units
« Reply #1 on: December 15, 2008, 06:37:44 PM »
If a unit for the rev code you are billing is 13-15 minutes then I would calculate how many units in a 12 hour shift (48 units?) and put that in the units for each date of service.  Also put the total amount for the 12 hours in the total charges column. 

The only part I'm not sure about is the '53 min = 4 units'.  Divide the number of minutes in a unit into 720 minutes (12 hrs x 60 min).

Michele
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missy1katie2

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Re: Billing service units
« Reply #2 on: December 16, 2008, 10:56:55 AM »
Hi thank you for your response.  I got the formula for calculating units from your the e book "How to fill ..: I am quessing the rev codes for the services I am providing are 0550 Licensed Vocational Nurse, 0570 Certified Nurse Assistant, 0560 Social Work.  0550 and 0570 do not make visits- they do a 12 hour shift each.  Would they be considered hourly or other since they do not do visits. This is a workers comp claim for a patient that has benefits through their life span due to a law suit.  Workers comp is requesting an ub 04 form. ???

Michele

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Re: Billing service units
« Reply #3 on: December 19, 2008, 01:25:59 PM »
When billing for 0550, 0560, & 0570 rev codes the following chart would show how to bill the services.  You would replace the last digit with the appropriate one:

1 Visit charge
2 Hourly charge
9 Other medical social services


So for a 12 hour shift you would bill 0572 with 12 units for a 12 hour shift.

Hope that helps.
Michele
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missy1katie2

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Re: Billing service units
« Reply #4 on: December 19, 2008, 03:50:32 PM »
Thank you so much.  I reply not sure what happened to it.  Do I need to use the value code boxes since these are all workers comp claims from the same provider and if so would that be number 15 and would the amounts be the money charges or the hours billed.  There are no other parties involved. Thanks so much, you are a life saver.

Michele

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Re: Billing service units
« Reply #5 on: December 19, 2008, 05:06:15 PM »
I found the following info on value codes:  (According to this you would enter the hours, and you would enter 12 hours as .12 cents, all the way over to the far right.

Correctly Reporting Value Codes on the UB-04 Claim Form to
Ensure Smooth Claims Processing

It has come to our attention that there is some confusion on how to report the value codes on the new UB-04. Value codes need to be entered in numeric sequence, starting in Form Locators 39a through 41a, 39b through 41b, 39c through 41c, and lastly, 39d through 41d, see example below.
In addition, when entering days, the number needs to be placed in the far right column of the Value Codes Amount field (in the cents field). For example, 19 days would be entered in the same position you would enter 19 cents. Days 1099 would be entered in the same positions you would enter ten to ninety-nine cents. Days 100999 would be entered in the same positions you would enter one dollar to nine dollars and ninety-nine cents.
The correct reporting of value codes is essential to the processing of your claims. For example, if you need to report 2 days and you report it as 2.00 PROMISeTM will not read the zeros as decimal places, and instead will interpret the number to mean 200 days. This will result in the claim being read incorrectly and may result in the claim being denied. Please refer to the correct and incorrect ways to report value codes displayed above.

Michele
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missy1katie2

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Re: Billing service units
« Reply #6 on: December 19, 2008, 08:13:24 PM »
Thank you, but I don't understand this. (1.) The boxes used first are the ones across not up and down. Go 39a,40a, 41a. (2.) Put in the value code (in my case 15 for workerscomp), (3.)then in the small cents boxes- put in the number of days per each service. Is that it.
Or do I use the 55,56,57 codes even though the codes state they are for visit hours.  Visits are not made in this case.  The shifts are 12 hours long for nurse and home health aide. Please help I almost there I think. Thanks a million.

Michele

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Re: Billing service units
« Reply #7 on: December 19, 2008, 09:30:45 PM »
I would put the 15 to indicate the workers comp, and I would put the 56 with 12 to indicate a 12 hour shift, etc.  I would put the number of days you are billing for on the UB04 for the value code amount on the 15. 

Good luck!   :)

Michele
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missy1katie2

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Re: Billing service units
« Reply #8 on: December 19, 2008, 10:33:45 PM »
Thank you.  I appreciate your help so much.  Merry Christmas.