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How to fill out the Ub 04 To 837i Mapping online
Filling out the Ub 04 To 837i Mapping is essential for ensuring that your claims are processed accurately in the electronic format used by Indiana Medicaid. This guide provides step-by-step instructions to help you complete the form efficiently.
Follow the steps to fill out the Ub 04 To 837i Mapping with ease.
- Select the 'Get Form' button to access the Ub 04 To 837i Mapping form and open it for editing.
- Begin by filling in the Billing Provider's Service Location. Enter the 9-digit ZIP code in the designated field on the form.
- Next, include the Billing Provider NPI. This is found in section 56 of the UB-04 form, which should be mapped to the 2010AA loop of the electronic 837I format.
- Provide the Billing Provider Taxonomy. In the form, reference section 81CC a or b to indicate the qualifier and taxonomy code for the billing provider in the 2000A loop.
- Now, fill in the Billing Provider LPI. This number should be noted in section 57 and mapped correctly to the 2010AA loop on the electronic form.
- Proceed to complete the Attending Provider Information. Reference section 76 of the UB-04 for the Attending Provider NPI and ensure proper mapping to the 2310A loop.
- If applicable, fill in the Operating Provider and Other Provider Information, referencing sections 77 and 78 respectively, ensuring each entry corresponds to the right location in the electronic 837I.
- Review all entries for accuracy before submitting. At this stage, users need to save changes, download, print, or share the completed form as necessary.
Take charge of your claims process by completing the Ub 04 To 837i Mapping online today.
The primary difference between UB-04 and the 837 format lies in their presentation: one is a paper form while the other is electronic. While both formats serve to report healthcare services, the UB-04 requires manual handling, while the 837 allows for electronic submission, facilitating quicker payments. Engaging with Ub 04 To 837i Mapping can help convert UB-04 details into 837 format, ensuring accuracy and improving the overall claims experience.
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