VII. STATE UNIFORM BILLING COMMITTEES (SUBCs):

A. State Uniform Billing Committees - it is recommended that states should continue to maintain and operate independent Uniform Billing Committees.

B. Who should be on a SUBC - at a minimum, the organizations represented on the NUBC may be invited to participate equally on the SUBC. The organizations represented on the NUBC and their national members have indicated they will work with each SUBC to ensure representation at this level from their respective constituencies.

Since the NUBC’s Uniform Bill and Remittance is designed for use by all institutional health care providers and payers, representation on the SUBC may also be sought from self-insured plans. These self insured plans include, but are not limited to, Third-Party Administrators (TPAs), Health Maintenance Organizations (HMOs), Skilled Nursing Facilities, Home Health Agencies, Professional Review Organizations (PROs) or their equivalent service bureaus, state insurance departments, state health departments, and other appropriate state agencies, state or area wide data consortiums, EDI health care standards groups, and other representatives of the health care community in addition to the State Hospital Association.

C. SUBC Point of Contact - it is recommended the SUBC identify one individual who will be the primary point of contact. The person’s name, title, organization, address and telephone number should be communicated to the NUBC secretary who will maintain a national roster.

D. Recommended Operating Guidelines:

1. Review and coordinate to the maximum extent possible statewide provider/payer adherence to the national NUBC’s data set and hard copy billing and remittance formats.
2. Define and control statewide assignment and use of undefined data fields and local use reserved coding ranges.Communicate these assignments and/or changes to the NUBC secretary for incorporation in the interstate Uniform Billing Manual.
3. Convene regularly scheduled meetings.
4. Develop request(s) for change to the national uniform billing data sets, and/or hard copy and electronic billing and remittance formats in accordance with established NUBC methodology. (See Section III)
5. Review and document operational/utilization problems of the NUBC’s uniform data sets and communicate in accordance with established NUBC methodology.
6. Review statewide provider/payer performance and resolve local issues, but communicate concerns with national implications in accordance with established NUBC reporting methodology. (See Section III)
7. Maintain a state uniform billing procedure manual.
8. As additional changes are distributed by the NUBC or developed locally, the SUBC will update its statewide manual. Appropriate documentation should be distributed to all SUBC members.
9. Maintain a statewide uniform billing training program.
10. The existing statewide training program should be kept current as updates are made to the state procedure manual. Appropriate documentation and/or materials should be distributed to all SUBC members. Provide current copies of the training to the NUBC Secretary, when applicable.
11. Continue to seek statewide commitment to use and accept the NUBC=s billing, remittance, and other related business data sets (either in paper or electronic medium). Wherever possible, encourage the use of EDI applications and development of national standardization of EDI billing, remittance and other claims related applications.
12. Coordinate the distribution to seek commitment from the provider/payer community for increased use of the NUBC=s data sets.
13. Maintain procedures for statewide distribution of NUBC information, materials, surveys, etc.
14. Maintain a log of "state use" fields (unlabeled form locators, as well as reserved coding ranges within form locators reserved for state use). Provide copies of the log to the NUBC Secretary whenever a change is made.
15. Monitor statewide health care EDI applications related to claims processing. Advise the NUBC of new developments and/or the introduction of uniform EDI activities.

The SUBC will be responsible for serving as the focal point to receive and distribute NUBC information materials, surveys, and other pertinent information related to claims processing issues.