UB04: tipo de documento

Información general

El UB-04, o CMS-1450, es un formulario de reclamación estandarizado que utilizan los proveedores de atención médica para facturar a Medicare, Medicaid y los seguros privados por los servicios institucionales. Incluye detalles esenciales sobre el paciente, los servicios proporcionados y los costes en los que se ha incurrido, lo que agiliza el proceso de reembolso de los centros sanitarios.

This Document Understanding^TM skill is extracting 26 regular fields and 6 column fields containing key data points of the UB04.

Particularidades

La habilidad está entrenada para detectar automáticamente datos como:

• Nombre de facturación, dirección de facturación, número de ID fiscal de facturación;
• nombre del paciente, dirección del paciente, DoB del paciente;
• fecha de admisión, hora de admisión, tipo de visita;
• código de valor, importe de valor.

Extracted fields

Nota:

If you are using using public endpoints, such as https://du.uipath.com/ie/invoices, all fields are available. However, if you are using custom-trained extractors, the availability of extracted fields is dependant on the version you are currently using. You can also check the list of fields and types on any endpoint in the /info/model object. To access this, simply add /info/model to any endpoint, like so: https://du.uipath.com/ie/invoices/info/model. For an enhanced reading experience of the fields list, it's recommended to install a JSON viewer extension in your browser.

Table 1. List of extracted fields for UB04

Nombre para mostrar	Nombre del campo	Tipo de campo	Tipo de contenido
Federal Tax Number	billing-tax-id-number	regular	String
Patient Name	patient-name	regular	String
Patient Address	patient-address	regular	String
Birthdate	patient-birthdate	regular	Fecha
Patient Gender	patient-gender	regular	String
Type of Bill	bill-notype	regular	String
Total Amount	total-amount	regular	Número
Other Procedure Codes	other-procedure-code	regular	String
Other Procedure Dates	other-procedure-date	regular	Fecha
Statement Covers Period From	statement-period-from	regular	Fecha
Statement Covers Period Through	statement-period-to	regular	Fecha
Admission Date	admission-date	regular	Fecha
Admission Hour	admission-hour	regular	Número
Admission Type	type-of-visit	regular	Número
Discharge Hour	discharge-hour	regular	Número
Principal Procedure Date	principal-procedure-date	regular	Fecha
Condition Codes	condition-code	regular	id-no
Fecha de creación	creation-date	regular	Fecha
NombreDelProveedor	provider-name	regular	String
Provider Address	provider-address	regular	String
Payment Name	payment-name	regular	String
Payment Address	payment-address	regular	String
Patient Control Number	patient-control-number	regular	String
Medical Record Number	medical-record-number	regular	String
Patient Identifier	patient-identifier	regular	String
Source Of Referral	source-of-referral	regular	String
Patient Status	patient-status	regular	String
Accident State	accident-state	regular	String
Billing Name	billing-name	regular	String
Billing Address	billing-address	regular	String
Page Number	page-number	regular	String
Number Of Pages	number-of-pages	regular	String
Total Amount Non-Covered Charges	total-non-covered-amount	regular	String
National Provider Identifier	npi	regular	String
Primary Provider ID	primary-provider-id	regular	String
Other Provider ID	other-provider-id	regular	String
Provider ID	tertiary-provider-id	regular	String
ICD Version Idicator	icd-version-indicator	regular	String
Principal Diagnosis Code	principal-diagnosis-code	regular	String
Other Diagnosis Codes	67-other-diagnosis-codes	regular	String
Admitting Diagnosis	69-admitting-diagnosis	regular	String
Patient Reason For Visit	patient-reason-for-visit	regular	String
PPS Code	pps-code	regular	String
ECI Code	eci-code	regular	String
Principal Procedure Code	principal-procedure-code	regular	String
Observaciones	remarks	regular	String
Authorization and Employer Information - Treatment Authorization Codes	treatment-codes	Elementos	String
Authorization and Employer Information - Document Control Number	document-control-number	Elementos	String
Authorization and Employer Information - Employer Name	employer-name	Elementos	String
Code-Code - Qualifier Codes	qualifier-codes	Elementos	String
Code-Code - ID 1	id-1	Elementos	String
Code-Code - ID 2	id-2	Elementos	String
Insured Informations - Insured's Name	insured-name	Elementos	String
Insured Informations - Patient's Relationship	patient-relationship	Elementos	String
Insured Informations - Insured's Unique ID	insured-unique-id	Elementos	String
Insured Informations - Group Name	group-name	Elementos	String
Insured Informations - Insurance Group Number	insurance-group-number	Elementos	String
Medical Service Details - Revenue Codes	revenue-codes	Elementos	String
Medical Service Details - Description	Descripción	Elementos	String
Medical Service Details - HCPCS/Rate/Hipps Code	hcpcs-rate-hipps-code	Elementos	String
Medical Service Details - Service Date	service-date	Elementos	String
Medical Service Details - Service Units	service-units	Elementos	String
Medical Service Details - Total Charges	total-charges	Elementos	String
Medical Service Details - Non-Covered Charges	non-covered-charges	Elementos	String
Occurrence - Occurrence Code	occurence-code	Elementos	String
Occurrence - Occurrence Date	occurrence-date	Elementos	Fecha
Occurrence Span - Occurrence Span Code	occurrence-span-code	Elementos	String
Occurrence Span - Occurrence Span From	occurrence-span-from	Elementos	String
Occurrence Span - Occurrence Span Through	occurrence-span-through	Elementos	String
Payer Informations - Payer Name	payer-name	Elementos	String
Payer Informations - Health Plan ID	health-plan-id	Elementos	String
Payer Informations - Release Of Information	release-of-information	Elementos	String
Payer Informations - Assignment Of Benefits	assignment-of-benefits	Elementos	String
Payer Informations - Prior Payments	prior-payments	Elementos	String
Payer Informations - Estimated Amount Due	estimated-amount-due	Elementos	String
Physician Information - Physician NPI	physician-npi	Elementos	String
Physician Information - Physician Qualifier	physician-qualifier	Elementos	String
Physician Information - Physician ID	physician-id	Elementos	String
Physician Information - Physician Name	physician-name	Elementos	String
Value Codes and Amounts - Value Codes	value-codes	Elementos	String
Value Codes and Amounts - Value Codes Amount	value-codes-amount	Elementos	String

Ejemplos

You can download a sample filled-in form from here.

También puedes obtener una vista previa del ejemplo de un formulario cumplimentado: