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Advice You - Medical Billing - NSF or UB-92
It is no longer a question in the medical billing community of what the best method of sending claims is. Electronic billing has numerous advantages over sendi
According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
ng paper claims including ease of transmission, lower cost, faster turnaround time and a number of other advantages. But what about the type of electronic form
; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.
Examples of combination products may in
Examples of combination products may in
t? The main ones today are NSF 3.01 and UB-92. So what's the difference and is one better than another? Which one should you use? Does it make a difference?
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
Will using one format over another give you more headaches in the long run? In this installment, we're going to discuss the basic differences between NSF 3.0
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
and UB-92, including the pluses and minuses of each.
The first thing that you need to know is that NSF 3.01 has been around a lot longer than UB-92. Back in
The first thing that you need to know is that NSF 3.01 has been around a lot longer than UB-92. Back in
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
he early days of electronic billing, it was the only option. Therefore, software manufacturers had to include it with their product if they were going to compe
ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
te in the marketplace. Because of this and because everybody was creating their own NSF 3.01 package, each software manufacturer had to do the best job they po
easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
sibly could. Because of this, NSF 3.01 was pretty much perfected. The only differences between the software packages was the interface for transmission. The
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
pecifications themselves were pretty solid.
Today, with the two formats available and NSF 3.01 no longer being the only choice, for a medical billing agency to
Today, with the two formats available and NSF 3.01 no longer being the only choice, for a medical billing agency to
and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
switch over to UB-92, there had to be a good reason. Well, there were several.
For starters, because it was a relatively new format, the software was a lot c
For starters, because it was a relatively new format, the software was a lot c
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
eaper than the software to send NSF 3.01 claims. For small medical billing agencies, this was a big plus, especially if they didn't have a large client base.
ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.
Following aspects would a
Following aspects would a
lso, the cost to process these claims was cheaper because the format itself wasn't as popular and agencies were trying to get companies to use it. But there wa
dd to the challenges in developing combination products:
Which markets to tap where the combination products can do fairly well?
Which combination prod
Which markets to tap where the combination products can do fairly well?
Which combination prod
s a downside to all this.
Because UB-92 was new, there weren't as many pieces of software to choose from. Most of them were also untested. The early failure
Because UB-92 was new, there weren't as many pieces of software to choose from. Most of them were also untested. The early failure
cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
ate of UB-92 transmission was great. The specifications were confusing and finding good programmers to create the code was not an easy task. So finding good s
tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
ftware was very hard.
Another problem was that because UB-92 was new, not every carrier accepted claims in this format. In the early days only private carrier
Another problem was that because UB-92 was new, not every carrier accepted claims in this format. In the early days only private carrier
t?
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
s accepted claims in this format. Even today, not every carrier accepts UB-92 format as a transmission method. So if you are thinking of going with UB-92, you
ping new procedures for reviewing their safety, efficacy and quality.
Professional from academic institutions, pharmaceutical industries, health care indust
Professional from academic institutions, pharmaceutical industries, health care indust
first better check to make sure that the insurance carrier you want to bill accepts claims in that format.
Today, the differences between NSF 3.01 and UB-92 ar
Today, the differences between NSF 3.01 and UB-92 ar
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
not quite as great. Yes, there are still insurance carriers that don't accept UB-92 claims. But more carriers are taking them. The downside is that because
.
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
UB-92 is becoming more popular, the cost has gone up since the early days. So the difference in cost between NSF 3.01 and UB-92 are not as great.
In the final
In the final
elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.
Companies that provide selfless information through particip
Companies that provide selfless information through particip
analysis, it all comes down to what your budget is and who you want to send your bills to. In most cases, either NSF 3.01 or UB-92 will get the job done nicely
tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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