Both Claim Formats on the Same Encounter

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Updated: 10/07/2024 | Views: 2387

If your practice bills CMS-1500 and UB-04 claims, there may be some instances where you need to submit both claim formats on one encounter. Tebra has a unique feature called the "hybrid encounter" which enables you to easily enter information one time (avoiding double-entry) on an encounter that necessitates both claim formats.

The "hybrid encounter" becomes applicable under the following conditions:

The practice bills both CMS-1500 and UB-04 claims. Review the Claim Formats section of the Encounter Options.
The patient on the encounter has both primary and secondary insurance.
The primary and secondary insurances each require a different claim format.

To complete the "hybrid encounter", review both New Encounter: Professional (CMS-1500) and New Encounter: Institutional (UB-04).