North Central Counties Introduction to Community Care's Claims ...

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Critical Claim Elements (cont.) Critical Details on a UB-92 • Box 82 Physician’s Name (Second Line) • Box 83A Other Physician’s Identification • Box 83B Physician’s UPIN Number • Box 84 Provider’s Vendor Name, Address, Zip Code. Information should mirror contract. 18
Critical Claim Elements (cont.) Critical Details on a UB-92 • Box 85 Name of Physician, Clinician or Facility named on the Authorization Report • Box 86 Date Bill Submitted 19
Page 1 and 2: North Central Counties Introduction
Page 3 and 4: General Claim Information Claims Of
Page 5 and 6: General Claim Information Our Inten
Page 7 and 8: North Central Timely Filing Standar
Page 9 and 10: Electronic Claims Submission Provid
Page 11 and 12: Critical Claim Elements Critical De
Page 13 and 14: Critical Claim Elements (cont.) Cri
Page 15 and 16: Critical Claim Elements (cont.) Cri
Page 17: Critical Claim Elements (cont.) Cri
Page 21 and 22: Critical Claim Elements (cont’) C
Page 27 and 28: Critical for Correct Payment • Me
Page 29 and 30: Initial Claims Submission - Paper
Page 31 and 32: Initial Claims Submission Provider
Page 33 and 34: Corrected Claims • Corrected UB-9
Page 35 and 36: Provider Facts What Diagnosis / Ser
Page 37 and 38: Reminders • The North Central Pre

North Central Counties Introduction to Community Care's Claims ...

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