Rural Health Clinic Billing Cheat – Fill Out and Use This PDF

The Rural Health Clinic Billing Cheat Sheet, crafted in Spring 2012, serves as a comprehensive guide for the billing processes specific to Independent, Provider-based, and Critical Access Hospital (CAH) Rural Health Clinics (RHCs). It delineates the billing procedures for office visits, hospital visits, nursing home visits (both Part A and not Part A), home visits, lab tests, technical components of diagnostic tests, flu and pneumonia shots and injections, other types of injections, office procedures, EKGs, and homecare plan oversight. To ensure accurate billing and reimbursement for the services rendered by RHCs, considering the nuances outlined in the cheat sheet is crucial. For a more detailed guide on how to effectively use this billing cheat sheet, click the button below.

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Rural Health Clinic Billing Cheat PDF Details

In the vast and intricate world of healthcare billing, the Rural Health Clinic (RHC) Billing Cheat Sheet emerges as a critical tool, particularly in the spring of 2012, designed to simplify and streamline the billing processes for RHCs. This comprehensive guide serves various types of RHCs, including Independent, Provider-based, and Provider-Based at Critical Access Hospitals (CAH), offering clear instructions on how to bill for different services using specific forms like UB-04 and 1500. It clearly delineates the billing procedures for office visits, nursing home visits (both Part A and not Part A), home visits, lab tests, technical components of diagnostic tests, flu and pneumonia shots, injections, office procedures, EKGs, and homecare plan oversight. The cheat sheet underscores that for most services, the use of Current Procedural Terminology (CPT) codes is not required, which significantly simplifies the billing process. Each service category is meticulously detailed with information on the bill type, how payments are to be made (whether cost per visit, fee schedule, or cost + 1%), and the relevant revenue codes. Additionally, it provides guidance on logging flu and pneumonia shots for cost reporting, bundling services to increase charges efficiently, and the specific use of modifiers for billing purposes. This cheat sheet not only aims to assist RHCs in accurately charging for their services but also in navigating the complex reimbursement landscape, ensuring that these vital healthcare providers can continue to offer essential services to rural communities.

Question	Answer
Form Name	Rural Health Clinic Billing Cheat
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	rural health billing cheat, rural health clinic cheat sheet, home health billing cheat sheet, clinic billing sheet

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Rural Health Clinic Billing Cheat Sheet

Spring, 2012

Description	Independent RHC	Provider-based RHC	Provider-Based
			RHC – (CAH)
Office visits	Bill: UB-04	Bill: UB-04	Bill: UB-04
	Bill Type: 711	Bill Type: 711	Bill Type: 711
	How paid: Cost per visit	How paid: Cost per visit	How paid: Cost per visit
	Revenue Code: 0521	Revenue Code: 0521	Revenue Code: 0521
	CPT Codes not required	CPT Codes not required	CPT Codes not
			required
Hospital	Bill: 1500	Bill: 1500	Bill: 1500
Visits	How paid: Fee schedule	How paid: Fee schedule	How paid: Fee schedule
	Use: CPT Codes	Use: CPT Codes	Use: CPT Codes
Nursing	Bill: UB-04	Bill: UB-04	Bill: UB-04
Home	Bill Type: 711	Bill Type: 711	Bill Type: 711
(Part A)	How paid: Cost per visit	How paid: Cost per visit	How paid: Cost per visit
	Revenue Code: 0524	Revenue Code: 0524	Revenue Code: 0524
	CPT Codes not required	CPT Codes not required	CPT Codes not
			required
Nursing	Bill: UB-04	Bill: UB-04	Bill: UB-04
Home	Bill Type: 711	Bill Type: 711	Bill Type: 711
(Not Part A)	How paid: Cost per visit	How paid: Cost per visit	How paid: Cost per visit
	Revenue Code: 0525	Revenue Code: 0525	Revenue Code: 0525
	CPT Codes not required	CPT Codes not required	CPT Codes not
			required
Home	Bill: UB-04	Bill: UB-04	Bill: UB-04
Visits	Bill Type: 711	Bill Type: 711	Bill Type: 711
	How paid: Cost per visit	How paid: Cost per visit	How paid: Cost per visit
	Revenue Code: 0522	Revenue Code: 0522	Revenue Code: 0522
	CPT Codes not required	CPT Codes not required	CPT Codes not
			required
Lab Tests	Bill: 1500	Bill: UB-04	Bill: UB-04
	How paid: Fee schedule	Bill Type: 141	Bill Type: 851
	Use: CPT Codes	How paid: Fee schedule	How paid: Cost + 1%
	Use: Clinic NPI Number	Use: CPT Codes	Use: CPT Codes
		Use: Hospital Outpatient	Use: Hospital
		provider number.	Outpatient provider
		Revenue Code: 300	number

Description	Independent RHC	Provider-based RHC	Provider-Based
			RHC – (CAH)
Technical	Bill: 1500	Bill: UB-04	Bill: UB-04
Components	How paid: Fee schedule	Bill Type: 131	Bill Type: 851
of	Use: CPT Codes	How paid: Fee schedule	How paid: Fee schedule
Diagnostic	Use: Clinic NPI Number	Use: CPT Codes	Use: CPT Codes
Tests		Use: Hospital Outpatient	Use: Hospital
		provider number	Outpatient provider
			number
Flu and	Log flu and pnuem.	Log flu and pnuem.	Log flu and pnuem.
Pnuem.	Shots and include on the	Shots and include on the	Shots and include on
Injections	cost report.	cost report.	the cost report.
All other	Bundle with the office	Bundle with the office	Bundle with the office
Injections	visit on the UB-04 using	visit on the UB-04 using	visit on the UB-04 using
	revenue code 0521. Will	revenue code 0521. Will	revenue code 0521. Will
	increase charges that are	increase charges that are	increase charges that are
	bundled into 0521.	bundled into 0521.	bundled into 0521.
Office	Bundle with the office	Bundle with the office	Bundle with the office
Procedures	visit on the UB-04 using	visit on the UB-04 using	visit on the UB-04 using
	revenue code 0521. Will	revenue code 0521. Will	revenue code 0521. Will
	increase charges. If you	increase charges. If you	increase charges. If you
	bill an E and M code use	bill an E and M code use	bill an E and M code
	modifier 25.	modifier 25.	use modifier 25.
EKGs	Bill the Professional	Bill the Professional	Bill the Professional
	component on UB-04	component on UB-04	component on UB-04
	(93010) and bill the	(93010) and bill the	(93010) and bill the
	technical component	technical component	technical component
	(tracing 93015) on the	(tracing 93015) on the	(tracing 93015) on the
	1500.	UB-04 with a 131 Bill	on the UB-04 with a
		Type and 730 Revenue	851 Bill Type and 730
		code.	Revenue code.
Homecare	During the initial period	During the initial period	During the initial period
Plan	when a face to face	when a face to face	when a face to face
Oversight	encounter is required,	encounter is required, bill	encounter is required,
	bill this code on the UB-	this code on the UB-04,	bill this code on the
	04, Revenue Code 521)	Revenue Code 521)	UB-04, Revenue Code
	Thereafter, since there is	Thereafter, since there is	521)
	not face to face, do not	not face to face, do not	Thereafter, since there
	bill for the service.	bill for the service.	is not face to face, do
			not bill for the service.

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