Box 38 - Responsible Party Name and Address

Box Definition

Box 38 will display the Responsible Payer's Name and Address on claims. The Responsible Payer can be the Primary, Secondary, or Tertiary Payer.

On Paper Claims

Both the Payer Name and Address for Paper Payers will always appear in Box 38.  If a claim is forced to paper through a correction or Service Grouping Rule, the Payer Address must be included in the Payer Profile within the Practice Admin as described below.

On Electronic Claims

Electronic claims always display the Payer's name in Box 38 but not the address. To include the address in the EDI of an electronic claim, the address must be added to the Payer Profile in Practice Admin, and a Claim Form Rule must be created to force it to appear. 

In Kipu RCM

The Payer's Name and Address are located in the Payer Profile within the Practice Admin and the Insurance Set of the Patient Profile. For information on updating the payer profile, click here. For information on updating the patient's insurance set, click here. 

EDI Loop/Segment

Not required.