HCFA AUDIT RULES (Field 26, 27, 28, 29)

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.

H26_Patient_Account_No		Key what you see.
H27_Accept Assignment	Only allowed values: Y N	Y=Yes   N=No
H28_Total_Charge		Punctuation and spaces are optional. Do not include dollar signs ($). All charge figures must be at least three digits.
Examples: - H28_Total_Charge If part of a multipage form and CONTINUED appears in the total field, do not key the word CONTINUED. Instead, leave the field blank As it appears on form: Acceptable entries: $107.60 107.60 107 60 10760 0 0.00 0 00 000 1,795.65 1,795.65 1795 65 179565 68-- 68.00 68 00 6800 68 - 68.00 68 00 6800
H29_Amount_Paid		Punctuation and spaces are optional. Do not include dollar signs ($). All charge figures must be at least three digits.
As it appears on form: Acceptable entries: $107.60 107.60 107 60 10760 0 0.00 0 00 000 1,795.65 1,795.65 1795 65 179565 68-- 68.00 68 00 6800 68 - 68.00 68 00 6800 Examples: H29_Amount_Paid If part of a multipage form and CONTINUED appears in the total field, do not key the word CONTINUED. Instead, leave the field blank.