Founded by the American Hospital Association (AHA) in 1975, the National Uniform Billing Committee (NUBC) works to create and maintain standardized billing materials for those involved with healthcare, including government institutions, private and public healthcare providers, and insurance companies.
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Experienced medical billing and coding professionals will be familiar with the fruits of the NUBC: the UB-04 form, one of the most standard medical claims forms used in the United States. With its origins reaching back decades, this form has made its latest evolution into electronic billing and is increasingly submitted virtually. In fact, 98 percent of hospital Medicare claims are submitted electronically, as are 80 percent of other institution claims.
Background of the UB-04
In 1968 three keys players were meeting to develop the structure for standardized claims in the United State. The first was the American Hospital Association (AHA). The second was the Healthcare Financial Management Association, a membership organization for financial management leaders in the healthcare industry. The third was the federal government. Together these agencies represented the bulk of the players who held a common interest in healthcare billing standardization.
Out of these meetings and over the course of four years there emerged no less than 13 different attempts at standardized medical billing forms, which were all summarily discarded. It was not until 1973 that the 14th attempt was evaluated in Georgia where it showed signs of promise. After a few tweaks its was also introduced in Wyoming where it proved to be a success. A few more trials and modifications later, the newly-created NUBC was ready to back the as-of-then end result, known as the UB-82. However this form would not be finalized by the NUBC until 1982.
From here the federal government did its part to help standardize billing and introduced state sub-committees to bring the UB-82 finished product into state legislatures, where the billing data it reported was adopted in one form or another by all states.
The UB-82 enjoyed a legally-mandated static period of no changes from 1982 until 1990, when it was upgraded to the UB-92. After this came the form all medical billers know today, the UB-04. Many of the following elements that were developed in the UB-82 will be recognized in today’s UB-04, and have been designed to reduce the need to include extra billing attachments:
- Elements that are essential for claims processing each have their own place (Form Locator) for data entry on the form
- Each Form Locator has a unique number
- Forms have a flexible data set – non-essential but often-used data can also be represented in general fields using specific codes, codes and amounts, or codes and dates
Future Work of the NUBC
Keeping up with the latest changes in technology and legislation keeps the NUBC busy enough. A good example can be found in the intersection of these two elements in HIPAA-compliant electronic billing, which the NUBC must ensure also includes all necessary and standardized data. But those are far from the only issues on the organization’s plate.
Today there are also more players involved in healthcare than just the original three who came up with the UB-82. The NUBC must keep its standardized billing data relevant, and that means including ways of coding that allow professionals like public health officials to draw conclusions about patient services purely from UB-04 data.
It goes without saying that billing and coding professionals will have plenty of excitement in the future as new standardizations are issued to meet the ever-changing modern environment.