Medicare Compliance & Reimbursement

Use these expert tips to prepare for the new UB-04 form.

By May 23, all institutional paper claims must use the new UB-04 form to accommodate the new National Provider Identifier (NPI) numbers. That means now's the time to make sure your software is ready to handle the new UB-04.
 
Update Your Software Because of the number and types of changes that the new UB-04 includes, your billing software programs will need updating to print your claims correctly.

Best bet: Contact your software vendor as soon as possible to make sure that it is ready to comply with the deadlines if you are transmitting your claims electronically, says Felice Landry, senior billing consultant with Reingruber & Company in St. Petersburg, FL. Find out what it intends to do to address the changes and when you can expect upgrades to occur. Even better, get the timeline from your vendor in writing to ensure that it delivers when it says it will.

Good news: If you're using the fiscal intermediary's free software, it will be compliant with the deadlines, Landry says. Start Using The UB-04 Early You aren't required to start using the UB-04 until May 23, but you can start submitting claims with it as early as March 1. 

That said, starting testing the new form as early as possible wouldn't hurt so you can keep an eye out for any unusual errors, Landry urges. "Just like when you replace software at home, you need to pay attention to those little bugs," she says. Important: If you find errors, be sure to share that information with your fiscal intermediary, Landry says.

Warning: Make sure that your new 10-digit NPI matches your current provider number. If you don't test the form to check this before May 23, all of your claims will be rejected, Landry says.

To prepare for the transition, Darlene Greenhill, healthcare consultant with Mauldin & Jenkins, in Atlanta, suggests that you:

• Review Transmittal 1104 to see the new instructions and format;

• Be aware of the transition dates;

• Make sure you have your NPI number; and

• Compare a hard copy of the UB-92 with the UB-04 to see the differences. Learn These Critical Dates The Centers for Medicare & Medicaid Services (CMS) stated in Transmittal 1104, released on Nov. 3, 2006, that the new UB-04 form implementation will be effective March 1, 2007.

Important: The new UB-04 form will be available to use starting March 1. But you won't be required to use the new form until May 23. During the transition period, carriers will accept both current and revised forms, meaning that you can use either the UB-04 or the UB-92, according to CMS:

• March 1-May 22: You can use either the [...]