Intellect™
UB04 TYPE OF BILL DETERMINATION
FOR ELECTRONIC CLAIMS IN INTELLECT
Intellect has three fields which determine which 3-digit Bill type appears on Institutional Loop 2300 CLM05-3 and CLM05-5 or UB-04 Paper Form Locater 4.
Charges --► Encounter --► UB Encounter <Bill Type>
Charges --► Encounter --► UB Encounter <Claim Frequency Code>
Utility --► Set Up --► Clinic <Facility Identification Number>
1. If there is a UB encounter attached to the claim during posting (or Charges --► Modify), then Intellect first checks Charges --► Encounter --► UB Encounter <Bill Type> for a three-digit value.
1.1 If there is a value, then these three digits are used first, unless Charges --► Encounter --► UB Encounter <Claim Frequency Code> has a value different than the third digit. This value overrides the third digit (Claim Frequency Code).
2. If there is NO UB encounter attached to the claim during posting (or Charges --► Modify), OR if Charges --► Encounter --► UB Encounter <Bill Type> is blank, then Intellect checks Utility --► Set Up --► Clinic <Facility Identification Number>.
2.1 If there is a value, then these three digits are used, unless Charges --► Encounter --► UB Encounter <Claim Frequency Code> has a value different than the third digit. This value overrides the third digit (Claim Frequency Code).
3. If Charges --► Encounter --► UB Encounter <Bill Type> and Utility --► Set Up --► Clinic <Facility Identification Number> are both blank, then no file for electronic submission is created.