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Form Locator Modifications - Registry Setting

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Avatar PM > Billing > Paper Billing > HCFA-1500

Control form locators for Paper HCFA-1500 billing by adding the indicated fields to the Paper CMS-1500 section of the Guarantor/Program Billing Defaults form.

'1' adds the Federal Tax ID Number (Form Locator 25) field. This enables the user to override the Federal Tax ID Number (Form Locator 25) on the HCFA-1500.

'2' adds the Form Locator 18 Display Admission/Discharge Date field. This enables the user to specify if the admission/discharge date should display within Hospitalization Dates Related To Current Services (Form Locator 18) on the paper HCFA-1500.

'3' adds the Form Locator 29 (Amount Paid) Exclude Adjustments field. This enables the user to exclude adjustments from the calculation of Amount Paid (Form Locator 29) on the HCFA-1500.

'4' adds the Financial Classes To Override Form Locator 9D (Insurance Plan Name Or Program Name) field. This enables the user to specify data for Rendering Provider ID (Form Locator 24I/24) within the Guarantor/Program Billing Defaults form.

'5' adds the fields Form Locator 9D Override (Insurance Plan Name or Program Name), and Financial Classes to Override Form Locator 9D (Insurance Plan Name Or Program Name). This enables the user to override Form Locator 9D (Insurance Plan Name or Program Name) on the HCFA-1500.

'6' adds the Use Client's Address for Service Facility Location (Form Locator 32) if the 'Place of Service' is 12-Home field. This enables you to use the client's address information from client demographics for the Service Facility Location Information (Form Locator 32) when the Place of Service for a service is 12-Home.

'0' removes all fields from the form.

 

Avatar PM > Billing > Paper Billing > UB-04

Override the Type Of Bill Frequency Code (Form Locator 4) on the paper UB-04.

'1' adds the Type of Bill Frequency Code Override field to the Paper UB-04 section of the Guarantor/Program Billing Defaults form. This enables you to select the value to be used in the fourth digit of the Type Of Bill in the UB-04.

'0' removes the field from the form.