Wiki Tricare and asc claims

[Tracy K]

Hello,

We are an ASC that bills out our orthopaedic facility claims on a HCFA 1500 forms but Tricare is requiring that these are submitted in the UB format. Our system is not set up that way nor has any of our staff billed or coded for this format.

If anybody is set up this way would you mind contacting me

Thank you for all the help
Tracy Kirke

tkirke@cascadeortho.net

 

[capricew]

tricare and asc claims

As a ASC coder myself, i am really surprised that you have been sending all of your commercial claims on HCFA 1500. However, it basically comes down to what your contracts with each commercial payer specifies. For instance, as an asc most of our contracts required us to bill on a UB04, with the exception of Medicare and Medicaid. We do however, have a few commercial payer where the contract states we must billl on a the HCFA 1500. Tricare has always required us to bill on UB04.
Needless to say your software program should have the capability to send both types of claims and the ability to specify in your program which claims are hcfa and which are ubo4. do you mind if i ask what software you use to bill with? you can email me if you like at
cwalder@promednv.com

Caprice W., CPC
Henderson, NV