Click here to return to the Charge Entry table of contents
This tab refers to fields that would be located on a UB-04 claim form.
- Admission Tab- Allows you to enter information based on admission fields.
- Admission/Discharge- Enter information based on admission and discharge.
- Admit Date- Select the admit date.
- Admit Time- Select the admit time.
- Admission Type Code- Select the admission type code.
- Admission Source Code- Select the admission source code.
- Discharge Time- Select the discharge time.
- Patient Status Code- Select the patient status code.
- Non-Covered Charges- Enter any non-covered charges.
- Charge- Enter the non-covered charges.
- Bill Type- Enter the bill type used for the charge.
- Facility Type- Select the facility type.
- Bill Classification- Select any bill classification.
- Frequency- Select the frequency of the claim.
- Medicare- Enter the patient’s Medicare benefits.
- Covered Days- Enter the number of days the patient is covered.
- Non- Covered Days- Enter the number of days the patient is not covered.
- Co-Insurance Days- Enter the number of days the patient pays for a portion of the claim.
- Lifetime Reserve Days- Enter the number of additional days Medicare will pay for (The additional days start after the patient has been in the hospital for 90 days).
- Occurrences Tab- Allows you to enter multiple occurrences and create duration for each one.
- Occurrences- Enter the type of occurrences and their corresponding dates.
- Occurrence Spans- Enter the length of time the occurrences will occur.
- Value Codes Tab- Allows you to assign values to codes.
- Value Codes- Enter the code and the corresponding amount.
- Conditions Tab- Allows you to enter multiple condition codes.
- Condition Codes- Enter the desired condition codes.