Tips for filing a request for anticipated payment

When filing a Request for Anticipated Payment (RAP), keep in mind the following:

  • The bill type in Form Locator (FL) 4 of the UB-04 is always 322 or 332
  • The “to date” and the “from date” in FL 6 must be the same and must match the date in FL 45
  • FL 39 must contain code 61 and the core-based statistical area code of the beneficiary’s residence address
  • There must be only one line on the RAP, and it must contain revenue code 023 and 0 dollars. On this line, FL 44 must contain the Health Insurance PPS code
  • The quantity in FL 46 must be 0 or 1
  • FL 63 must contain the treatment authorization code assigned by the outcome assessment information set