Box 1 - Billing Provider, Address, Phone Number

Box Definition

Box 1 on the UB-04 claim form displays the Billing Provider Name, Address, and Phone Number.

In Kipu RCM

The billing provider information is managed under the Insurance Billing tab within the Practice Admin section. For more information on updating the tax ID, click here. 

EDI Loop/Segment

Loop 2010AA, Segments N3 & N4. For additional information on loops and segments, click here.