Many milestones in healthcare have come and gone since Logik Solutions began serving clients in 1988. The evolution of the UB-82, UB-92, Y-2K, prospective payment initiatives and HIPAA standardized electronic formats all affected the evolution of our software and our clients’ billing practices.

Logik Solutions’ clients were ready for these events. The UB-04 implementation was on our radar before February of 2005 when the National Uniform Billing Committee (NUBC) approved the UB-04 as the replacement for the UB-92. Now that final regulations are promulgated Logik Solutions is ready, and so are our clients.

Some of the new features of the UB-04 include additional data fields including:

• Capacity to report the National Provider Identification Number

• Recoding taxonomy code of the facility or in the case of professional component billing the rendering provider

The UB-094 implementation schedule for institutional, home health, SNF’s, hospices and certain other providers is outlined below:

March 1, 2007: Vendors, facilities, clearing houses and other links in the billing chain must be ready to commence printed claims submission using the new UB-04. Providers may use either the UB-92 or the new UB-04 format until May 23, 2007.

May 23, 2007: The “drop-dead” date. After May 23, 2007, only the printed UB-04 will be accepted by Medicare Fiscal Intermediaries, and, then only for facilities exempted from PPS electronic submission requirements. Claims, previously generated on the UB-92, but re-submitted on or after May 23, 2007, must be conveyed on the new UB-04.

Logik Solutions’ clients are largely unaffected since the preponderance of all claims are conveyed in the HIPAA compliant electronic format to Medicare, Medicaid FI’s, and most third party payers.

Will there be waivers for payers that are unprepared for the UB-04 conversion? It’s likely. As was the case for the HIPAA electronic submission deadlines in 2005, a number of payers, and even several State Medicaid entities just were not ready. Logik Solutions continued to support both the HIPAA formats and various iterations of the pre-HIPAA electronic files. So too, we will provide our clients with the tools that get their claims paid regardless of the format—as we all work towards this implementation.

For more information regarding the UB-04 conversion follow this link:

http://www.nubc.org/public/whatsnew/UB-04Proofs.pdf