Get Swing Bed Billing Manual Form

This guide provides a clear and supportive approach to completing the Swing Bed Billing Manual Form online. Whether you are new to medical billing or have experience, the following instructions will help ensure that you fill out the form accurately and efficiently.

Follow the steps to complete the Swing Bed Billing Manual Form online.

1. Click the ‘Get Form’ button to obtain the form and open it for completion.
2. Begin with FL1, where you should enter the provider's name, address, and telephone number. Ensure all information is accurate and complete.
3. In FL3, input the patient control number if available; this is optional, but it helps track the claim.
4. For FL4, enter the 3-digit type of bill as mandated, specifically using Bill Type 181-184 for swing bed claims. Verify that no other Bill Types are utilized.
5. In FL6, specify the statement covers period by entering the first and last date of service, ensuring these are in MMDDYY format.
6. FL7 requires you to enter the number of covered days that coincides with the statement covers period; ensure these figures match.
7. Leave FL8 blank as non-covered days will automatically be calculated.
8. Proceed to FL12 and enter the patient’s last name, first name, and middle initial as required.
9. In FL14, provide the patient’s birthdate in MMDDYYYY format.
10. Enter the admission date in FL17 in MMDDYY format, followed by the hour of admission in FL18, which is required.
11. For FL19, specify the type of admission using the relevant code from the provided list.
12. Input the source of admission in FL20, referencing the categorized list of options.
13. FL21 requires the hour of discharge, while FL22 needs the discharge status code; refer to the discharge codes list to ensure accuracy.
14. In FL42, enter all appropriate revenue codes in ascending order, as specified for swing bed claims.
15. In FL44, input the accommodation rate for room and board to prevent claim rejection.
16. Ensure to fill FL45 with the first date of service for the relevant revenue code and state the number of units of service in FL46.
17. Complete FL47 with total charges per revenue code before proceeding to FL50, where you list the payer organization's name.
18. In FL51, enter your North Dakota Medicaid Provider Number assigned for swing bed services.
19. FL54 requires you to input prior payments received from other payers, excluding Medicare.
20. Finally, in FL55, state the estimated amount due. This entry is crucial to maintain the claims processing.
21. Enter the recipient's information in FL58 and FL60 before inputting the principal diagnosis code in FL67.
22. Ensure FL85 is signed and dated by the appropriate representative, and enter the submission date in FL86.
23. After completing all the necessary fields, save changes to your form, then download or print it for your records or submission.

Start filling out the Swing Bed Billing Manual Form online today for efficient medical billing!