HCFA AUDIT RULES (Field 5)

Forms must be keyed in all CAPITAL LETTERS.
  
“Key what you see” means to literally key what you see. You are trying to replicate the form as it was submitted; you cannot fix errors.

Field No	HCFA	COMMON VALUES	RULE
5	H05a_Patient_Address		Key what you see.
5	H05_Patient_City		Key what you see.
5	H05_Patient_State		Key what you see. It should be a two-letter abbreviation but if it is NOT, you still must key what you see.

 Example : (H05_Patient_State)

State as is appears on form:	State as it should be entered:
NY	NY
New York	NEW YORK
N.Y.	N.Y.
TENN.	TENN.
SAME	SAME

 

Field No	HCFA	COMMON VALUES	RULE
5	H05_Patient_Zip		Hyphens and spaces are optional. If a digit is missing, just key the digits that are there.

Example : (H05_Patient_Zip)

As it appears on form:	Acceptable entries:
02715			02715
61380 4666	61380-4666	61380 4666	613804666
99478-61	99478-61	99478 61	9947861

Field No	HCFA	COMMON VALUES	RULE
5	H05c_Patient_Phone		Parens, dashes and spaces are optional.

These all are acceptable Entries : (H05c_Patient_Phone)

(309) 487-1234

309) 487-1234

309-487-1234

309 487 1234

3094871234