N.J. Admin. Code § 8:31B-2.4

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:31B-2.4 - Guidelines for completion of the patient billing and abstract form

(a) Procedural guidelines for completing the patient billing and abstract form follows:

1. Guidelines for completing the billing form have been developed by the NUBC for Medicare, Medicaid, TRICARE, and commercial insurers.

2. Specific instructions for Blue Cross, Medicaid, and other payers will be provided by those payers.

3. Additional data elements required for the Department by this rule are described in detail by an addendum to the National Uniform Bill Manual. Note: The addendum consists of instructions for filling out the new, Federally mandated form; copies of the addendum can be obtained from the Department.

(b) Billing timelines requirements are as follows:

1. A UB shall be completed, finalized, and submitted to the data intermediary for each patient within 30 days of discharge of the patient.

2. Where claims administration and cash flow considerations would dictate a more current billing than the 30-day requirement, a preliminary version of the UB containing only those items required for the particular payer need be utilized at the time of billing. In interim billing cases, it is required that the full patient billing and abstract information be completed and submitted to the data intermediary in compliance with the data intermediary time limits and these rules, specifically N.J.A.C. 8:31B-2.5(g). Data items reported to the data intermediary for transmission to the Department shall not differ from data upon which payment was based.

3. The hospital shall submit discharge data daily to the data intermediary. That daily submission shall include the data on all discharges billed the previous day.

N.J. Admin. Code § 8:31B-2.4

Amended by 50 N.J.R. 1494(a), effective 7/2/2018