View the UB-92 Representation

The UB-92 Representation is rendered from actual claims data that has been imported from your facility. The data is presented in the field locators as it would appear on an actual UB-92.

By default, Contract Manager displays data in the form it was received. For example, UB-04 claims are displayed in UB-04 format and UB-92 claims are displayed in UB-92 format. However, you can override the way the data displays to either format. For more information about setting UB display preferences, refer to Edit UB Display Preferences.

Note: The UB-92 representation displays within the Contract Manager page.

Procedure

  1. Access the UB-92 Representation page.

    If you know the account number:

    • Select Go To > Account Research > By Account Number. The Account Research by Account Number page opens.
    • Type the account number and click Display Account. The Patient Account Audit page opens.
    • Click the UB92 link in the View column. The UB Representation page opens.

    If you do not know the account number:

    • Select Go To > Account Research > from Worklist. The Account Research from Worklist page opens.
    • From the Task list, select Create Worklist.
    • Specify other selection criteria and click Display Accounts. The Account Worklist page opens. For more information about search criteria, refer to Specify Account Worklist Criteria.

      Note: PEM claims are not included in worklist results.

    • Click the account number you want to review in the Account Number column. The Patient Account Audit page opens.
    • Click the UB92 link in the View column. The UB-92 Representation page opens.
  2. Review the UB-92 representation.

    Values in the Diagnosis, HCPCS / RATE / HPPS CODE, and Principle Procedure Code fields are links to additional information about the diagnosis code.

    • Click the link to view basic information about the code.
    • KnowledgeSource subscribers can log in to KnowledgeSource to view detailed information about the code.
  3. To print the UB-92 information, click one of the following links at the top of the page:
    • Click View Printable Form(s) to display a printable facsimile of the standard UB92 form and its data.
    • Click View Printable Form(s) - Data Only to display a printable page of data from the UB-92. This option prints all the information but excludes borders, headings and shading.

      Note: The first time you click one of these two links, the Security Warning page prompts you to install and run the “Form Printing Assistant.” You must click Yes on this page to print the UB information correctly.

      The Printing Assistant adjusts several Internet Explorer print settings (margins, background color printing, headers and footers) so that your UB is printed properly. When you leave the page, the Printing Assistant returns the Internet Explorer print options to their original settings.

  4. Click Back on the menu bar to return to the previous page.