Author Topic: facility set-up  (Read 1692 times)


  • Newbie
  • *
  • Posts: 8
facility set-up
« on: November 30, 2010, 03:48:36 PM »
We are working with a provider who is going to be taking over an outpatient facility. It is owned by a hospital and presently run by a managing company. We're in the beginning of this so I may not have the correct understanding yet, but as the facility (ownership) is already established, I think we need to change the managment and billing entity (the billing is not being done by the hospital, but by the management company and will be done by us). As I have not done this for a facility, I am not sure I am correct, so please correct me if I am not. I have searched for the proper forms, but perhaps am looking in all the wrong places. If somebody can set me in the right direction, and provide better understanding, I would greatly appreciate it.



  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4949
    • Solutions Medical Billing
Re: facility set-up
« Reply #1 on: December 03, 2010, 08:10:08 AM »
Are you going to be billing the facility charges or professional charges?  The facility charges are billed on UB04 forms.  Professional charges would still be billed on the CMS 1500.  We do have a resource for learning how to complete the UB04 forms.  You can read mores about it at

Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF


  • Newbie
  • *
  • Posts: 40
Re: facility set-up
« Reply #2 on: January 20, 2011, 11:39:59 AM »
so is it going to not be owned by the hospital anymore?? aka freestanding?? I work at a freestanding and we do not use UB04 we bill on HICFA 1500 forms. whole different ball game then the UB04. I would also look into your specific state billing guidelines. The billing guidelines for freestanding facility is alot more restricted than for hospital owned ASC's. The reimbursement rates are far lower and there are far more restrictions on billing.