Box 33 - Billing Provider Info and Ph#

Box Number

Box 33 shows the billing provider's name, address, and phone number.

In AveaOffice

To change the billing provider information on a claim form:

1. Navigate to Practice Admin > Configuration > Insurance Billing.
2. Click to Create Scheduled Change Set or edit the baseline.
3. Edit the Name, Address, City, State, Zip Code, or Phone fields.
   
4. Click Save.

EDI Loop/Segment

Loop 2000AA, Segment NM103 (Last Name or Organization Name), NM104 (First Name), NM105 (Middle Name/Initial), NM107 (Suffix), N301 (Street Address), N302 (Street Address 2), N401 (City), N402 (State), N403 (ZIP Code), PER04 (Phone Number).