Previous Page TOC Index Next Page

6.5.3 Update patient accounts - update UB82 information

MSH|^~\&|UREV||PATB||||BAR^P01|MSG0018|P|2.3<CR>
PID|||125976||JOHNSON^SAM^J|||||||||||||125976011<CR>
UB1|1|5|3|1||1^36|||220|76|1|19880501|19880522<CR>

Utilization review sends data for Patient Billing to the Patient Accounting system. The patient’s insurance program has a 1-pint deductible for blood; the patient received five pints of blood, and three pints were replaced, with one pint not yet replaced. There is a UB82 Condition Code 1.

The patient has been assigned to a Special Unit because no General Care beds are available (UB82 condition code 36). Additionally, the patient has been scheduled for out-patient pre-admission diagnostic services in preparation for a previously scheduled admission; the cost of these services is $220. The patient’s services are related to a special program, defined by the insurance plan as plan 76.

The services provided for the period 05/01/88 through 05/22/88 are fully approved (PSRO/UR Approval Code 1), including any day or cost outlier.

Previous Page TOC Index Next Page