Hospital UB-04 forms in use starting in March

Software changes may be necessary

While the impact of new hospital billing forms will be felt more by the business office than the front end, access personnel also should be aware of the change, since the information they collect feeds into the billing system.

The new UB-04 medical claim form, which replaces the UB-92 form, will be available earlier in the year, but will not be accepted for billing until March 1, 2007. The form will be phased in over a transition period from March 1 to May 22, and used exclusively for hospital billing beginning May 23, 2007.

The UB-04 data set accommodates the National Provider Identifier (NPI) and incorporates a number of other changes and improvements. They are more in line with the 837 format.

Many of the data elements referenced in the UB-04 data set and corresponding manual are also used in the Health Insurance Portability and Accountability Act's electronic claim standard.

Providers that are submitting claims electronically should contact their software vendors well in advance of the deadline to find out what changes need to be made to their systems to allow for the new format, says Michele Redmond, co-owner of Solutions Medical Billing Inc.

Those submitting UB forms on paper should make sure their software is capable of printing the new UB-04 format, she adds. "Unless you recently upgraded your software, most likely it will need some changes."

Redmond suggests that providers look into the changes that need to be made right away to avoid glitches that could disrupt the organization's cash flow.