UB04: Additional Claim Information
Contents
The occurrence and occurrence span codes are captured in the UB04: Additional Claim Information section. InSync users can print the UB04 paper claims with these codes. Also, the users can transmit the UB04 claims to the clearinghouse electronically by capturing occurrence and occurrence span codes. The user can enter these codes in the system from the New Charge screen.
To capture Occurrence and Occurrence span codes:
| 1. | On the New Charge screen, select the Billing Type as UB04 (Institutional). |
| 2. | Expand the “UB04: Additional Institutional Claim Information” panel. |
| 3. | Do the following: |
| • | First 4 boxes are to capture the occurrence codes (box number 31 to 34 on the UB04 claim) |
| • | Remaining 2 boxes are to capture the occurrence span codes (box number 35 and 36 on the UB04 claim) |
Note: When the user enters the occurrence/occurrence span code, the users must enter the date/period and vice versa.