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Tonight, we have Dawn. Now, if you’ve been on some of our past webinars, you may have met Dawn.

Alicia:  There she is.

Boyd:   Taadaa!

Dawn:  Hey, how are you?

Boyd: We’re doing great, how are you?

Dawn: Hangin’ in there.

Boyd: You’re still alive and well, great. Thanks for joining us here tonight.

Dawn: Cool!

Alicia: Dawn is our billing course instructor. It’s an intense but fun course. Dawn likes to make it kind of light but there’s a lot of information going on in the textbook that we have. We had a question come in to the forum that it was perfect for Dawn, so we had it come in tonight regarding the 1500 forms versus the UB 04 forms. This ASCs stands for ambulatory surgery centers, if you didn’t know.

Q: The question is, Dawn: Do ASCs use the CMS 1500 or UB 04 forms?

Here’s a picture of both of those…

Medical Billing Online CMS 1500 or UB 04 Forms – Video

Dawn:  A: Actually, Alicia, that’s a really good question. It’s actually a question that I once had. If you don’t do ambulatory surgery coding, it’s not something that you would just naturally know. What all medical billing students are taught is that inpatient billing is done on theUB 04and outpatient billing is done on the CMS 1500 form. So, an ambulatory surgery centers kind of in between both of them, so what do you use? The answer is both forms are used depending on what type ofASC you’re billing for.

If the surgery center is part of the hospital, you’re probably going to use the UB 04 form because hospitals use that form. They keep everything standardized, it’s part of the hospital, they’ll bill on the UB 04 form. If it’s a freestanding ambulatory surgery center not associated with the hospital, it will probably bill out using the CMS 1500 form as to the outpatient facility would.

The main difference between the UB 04 form and the CMS 1500 form is the CMS 1500 is basically has less stuff on it, like less spaces for stuff, because when we go to the doctor and you have an encounter there’s only so many things that’s going to happen in that kind of a setting. Whereas, when you’re in the hospital they’re scanning everything. They bring you a Q-tip, they’re going to scan that thing in for $10 now on your chart; so you need a lot more spaces for everything. That’s why the UB 04 inpatient is much more complex than the CMS 1500 form.

So, basically, my long-winded answer is, if it’s a freestanding ambulatory surgery center it will go on the CMS 1500. If it’s part of the hospital, it will be billed on the UB 04.

Also, I wanted to mention about the medical billing course that I’m a coach or instructor for. I really like this course and the reason is we have the textbook component, which is the best textbook in the industry. It’s the same one the AAPC uses, so I’m expecting that our students will have absolutely no problem passing the board exam. We didn’t put a bunch of fluff in the course where students are doing tons and tons and tons of busy work. Adult students want to get into a course and they want to get out of the course and they want to get a job. So, we have the textbook, we have online webinars. There are different types of learners, some people learn by reading, some by hearing.

And then I’m available, people can ask questions too. You can leave the proper email address; they can forward on to me any students or people out there that have questions about the billing course. You can give the email address that you want them to have, and then I know what’s our helpdesk address, but I don’t remember off the top of my head.

Boyd:  helpdesk@

Dawn: Yeah. Email that if youhave any questions about our billing course and I’ll be happy to help you and answer any questions you might have. Briefly, the course takes about 12 weeks, so in three months you can start a whole new career. In my opinion, there’re very few things you can do in this work, you train for for 12 weeks and get out make good money.

Alicia: True, this is one.

Dawn: Yes, it is. With the new ObamaCare legislation and more people accessing healthcare, there’s a need now for medical billers.

Alicia: I would mention too and Dawn can correct me if I’m wrong, but it’s a lot easier to get a job as a biller than it is a coder.

Dawn:  Yes.

Alicia: There’s a little bit more of a turnover rate, there’s just more jobs available. There’s more billers out there needed. So, that is something that if you’re wanting to get your foot in the door quickly, you might go ahead and make sure that you have that knowledge in billing. A lot of people start out in billing and then transfer into the coding when they get their coding certification. They’re kind of sisters in the field. Wouldn’t you say that, Dawn?

Dawn: I agree Alicia, and every single one of my billing students ask me the same question: should I learn medical coding? My answer is always yes. Coding and billing go hand-in-hand; if you learn one, you just go ahead and train into the other. Plus the fact either one is going to require continuing that out.

Alicia:  That’s right.

Dawn: So, if you take the billing course and you pass the board exam, you’re going to need to continue, go take a coding course, learn that too, and you’re even more qualified and vice versa.

Alicia: Right.

Dawn: Yeah.

Alicia: Those CEUs you get for each course will correspond for the other, so that’s fantastic. Again, like Dawn said if you have questions in our forum, you can come there and ask them, with lots of people who are new, or what will be a word for – if you’ve been doing it a long time that sounds nice.

Boyd:  Seasoned.

Alicia: Seasoned! Oh, there you go veteran, seasoned. OK, we’ve got lots of veterans and seasoned coders and billers in there, they can answer your questions, and we learn from you guys as well. So, I really appreciate you Dawn for coming in and talking about that, taking some time out of your night.

Dawn: Thanks for having me, I appreciate it.

Alicia: When you go in and take that course, it’s exciting and fun, and they go through it really quick. So, you don’t have to worry about it being adult.

Dawn:  Yeah. I don’t like people to get lost in my course. That’s the one thing that…

Alicia: That’s true.

Dawn:   …I really do. If you have too much content in a course, too much material, too much for the adults going to do; these people have jobs, spouse or kids, they get lost in it and will drop out and quit. I don’t like that, so when we created this, we gave enough content but you know I said cut out all busy work. I don’t want to include the workbook.

Alicia:  Right.

Dawn:  I don’t want to include all these strenuous stuff. They got what they need; they’ll pass the exam, and they’ll work.

Alicia: Yup! Thank you Dawn.

Boyd:  Thanks Dawn for coming.

Find out More Details about Medical Billing Online CMS 1500 or UB 04 Forms

Online Medical Billing Course

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AAPC – CMS – 1500 Questions

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READ THIS LATER! DOWNLOAD THE PDF >> CLICK HERE <<
2016-11-20T23:37:44+00:00

About the Author:

AliciaScott-Instructor
Alicia has been working in the medical field for over 20 years. She first learned about medical coding while working in a medical records department at a resort town hospital near where she was raised. Through the years she has held several jobs in the medical field from, CNA, EMT, Pharmacy technician and Medial Records Abstractor and Analyst. Outside of the medical field she has worked as a Real Estate agent, and owned her own on-line retail business. The medical field has always been where she felt the most comfortable. Alicia has taught medical coding, billing and medical law and ethics at a private college. She also did contract work in HCC Risk Adjustment and discovered she really enjoyed ICD work. Because she loves to learn Alicia is working towards her Masters in Health Care Administration with an emphasis on education. Having taken many online classes through the years to complete her degree she feels very comfortable with both face to face and on-line learning. Alicia will tell you that not only does she love medical coding but she has a passion for teaching it. Alicia lives in the middle of Texas with her husband who is a Pastor, five of her six children, three dogs and two cats.

2 Comments

  1. Donna Marchesano July 24, 2015 at 9:51 am - Reply

    Please give me direction on the correct way to bill CMS 1500 when doing facility outpatient billing and a Dr. uses the facility as a satellite office. Is it correct to use his name in box 31 rather then facility name, when using his NPI and taxonomy code ? Thank you for your assistance

  2. JoAnne Sheehan
    JoAnne Sheehan July 29, 2015 at 12:57 pm - Reply

    The location code in box 31 is the outpatient facility. Use POS 22 as the location on a CMS 1500. Npi belongs to the provider rendering the service and if he belongs to a group, the group name and group npi in box 33. Otherwise, box 33 would hold the solo doctor’s name and individual npi.

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