Institutional Billing

This page will explain how to create and navigate an institutional claim, otherwise known as UB04.

Options

With the inclusion of institutional claims there are several new options in TRAKnet. To access these options, click on the Tools drop-down menu then select Options.

Under the Billing category:

  • Medical Billing Preference - Professional or Institutional. This will determine what type of encounter is created on default.

Under the Claims category there are three new options:

  • UB04: Top Margin — This setting will allow you to adjust the top margin on a UB04 form.
  • UB04: Left Margin — This setting will allow you to adjust the left margin on a UB04 form.
  • UB04: Type of Bill (Box 4) — This setting will allow you to default the type of bill that will populate into Box 4 on a UB04.

Printers

You are also able to add a default printer for UB04 claims from TRAKnet.

You can manage the printers in TRAKnet by clicking on your UserName in the upper right-hand corner of TRAKnet then selecting Manage Printers. The third option on this screen will be for UB04 Paper Claim Forms. To set a printer, click on the drop-down menu and select your desired printer. Note that for a printer to appear in this list it must be visible by your PC. If your printer is not available in this list, please contact your IT professional for assistance setting up the desired printer.

Procedure Codes

There are two new fields under the Properties tab that contain all procedure codes for institutional claims. These are:

ICD-9 Procedure Codes
ICD-10 Procedure Codes

While ICD-9 procedure codes will be pre-populated, the user must import the ICD-10 Procedure codes. To import these codes, click on the ICD-10 Procedure Codes category then click Import button in the upper left-hand corner of the screen. You will then need to browse to the .csv file of Procedure Codes, provided by TRAKnet, then click Open. Please note: This process may take several minutes to complete and TRAKnet may show "Not Responding" during the process. This is normal. After some time the process will complete and all Procedure Codes will be present.

Creating an Institutional Claim

To create an institutional claim, create an encounter and while on the encounter creation screen, check the check-box for Institutional as seen below:

institutional.PNG

Then click the Start New Visit button. This will create the encounter.

As with Professional claims, the Visit Note, Diagnosis, and All Documents tabs will remain unchanged. The invoice tab, however, will now reflect UB04 billing.

Invoice

institutional2.PNG
The invoice screen will have two views in an institutional encounter:

Charges
Payments

To add a new charge, click on the green + on the right-hand side of the invoice tab. This will open the list of all CPT codes automatically filtered to show only institutional codes.

To modify a charge, double-click on the line item. This will open the Modify Patient Treatment window, which contains the following tabs:

  • Treatment - The screen where service date, charge, quantity and modifiers are placed.
  • Surgical Visit - The screen where Procedure Codes and/or HCPCS/HIPPS codes are added.
  • Comments - General, free-text comments about the line item.
institutional3.PNG

Claim Details

The Claim Details tab will vary greatly from the claim details tab of professional claims, as seen below:

institutional4.PNG

On this screen, you will be able to modify each individual box for the appropriate information. On the right-hand side is a claim check, alerting the user to any issues with the claim. The ANSI 837 Preview and the UB04 Print Preview buttons will allow the user to preview the institutional in either an electronic or paper format, respectively.

Note: To use ICD-10 Procedure Codes rather than ICD-9 you must click on the ICD-10 radio button next to the Code Format field.

institutional5.PNG

Sending

Sending a UB04 claim is performed the same as sending a professional claim.

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