Medical Billing - FB2 Record

In our previous installment, we covered the FB1 record for medical billing of claims using NSF 3.01 specifications for electronic billing. In this installment we're going to cover the FB2 record, which actually ties directly to the FB1 record.

While we did not go over the FB1 record in detail, we did briefly explain what information was transmitted as well as why the information was required to be sent. The FB1 record sent the four providers identification numbers along with some other information. The FB2 record sends three of the four providers addresses. We'll explain shortly why only three. The most common question that gets asked is why all this information doesn't just get transmitted in one record. To answer that question one first needs to know something about NSF 3.01 specifications and then the specific structure of each record. Since we didn't go over the FB1 record in detail, now would be a good time to briefly go over the structure.

The FB1 record primarily sends the providers names, positions 73 - 105, 121 - 153, 169 - 201, 217 - 249, UPIN numbers, positions 106 - 120, 154 - 168, 202 - 216, 265 - 279 and a few other pieces of uncommon information including patient ID, line item control number, place of service number, supervising provider NPI and of course the sequence number of the claim. The first 279 characters of the record are all filled with data.

Now, as you may or may not know, the NSF 3.01 specifications allocate 320 characters to each record. This was decided after determining that the information needed for the longest record, the FA0 record, would need to be 320 characters in length. Because they felt it would be easier to process claims if each record was the same length, they decided to make all the records 320 characters in length, even if they fell short. The way to compensate for this was to fill the remain characters with filler or blank spaces. This is not the same thing as leaving the record empty. At the end of the 320 characters, including blanks, a carriage return is inserted so that the payer would know that it is the end of the record. Because of this, if you take the 279 characters of the FB1 record and subtract them from the 320 total characters, you end up with 41 characters left over.

Now is where we have to look at the information for the FB2 record to understand why it couldn't be included in the FB1 record even though it applied to the same three of four providers. The FB2 record transmits the following information

1. Patient ID of 17 characters. 2. Record Type of 3 characters. 3. Sequence number of 2 characters. 4. Line item control number of 17 characters. 5. Provider indicators of 2 characters times 3 providers, which equals 6 characters. 6. Provider address of 91 characters times 3 providers, which equals 273 characters.

If you add up all the above, you will see that it comes out to a lot more than the 42 characters that we had left in our FB1 record. This is why the FB2 record needed to be created.

As to why only three of the four providers are sent in this record, the reason is simple. This is commonly referred to as your supporting provider's record. The info sent is for the ordering provider, referring provider and supervising provider. The rendering provider is not included here because he is the actual one rendering the service and his info was transmitted earlier.

Is it a messy system? Well, it certainly can be confusing. But for now, it's all we have.

In our next installment on medical billing we'll be looking at the GA0 record.

Article Source: http://www.content.onlypunjab.com

Michael Russell Your Independent guide to Medical Billing

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