Claim Form Rule: Use Practice Billing Provider Address as Billing Provider Address

  • Updated

What claim change is needed?

Use the Practice Billing Provider Address listed in Practice Admin > Configuration > Insurance Billing as Billing Provider Address.  A claim rule is not required to add the practice billing provider address because the address listed in Practice Admin > Configuration > Insurance Billing is the default for claims. However, if there is already a claim rule set up for some conditions to use Facility Address as Billing Provider Address, you may need a second rule to set the billing provider address back to the practice address for other conditions. 

Box Number

UB-04: Box 1

CMS-1500: Box 32

CMS-1500: Box 33

Steps

  1. Navigate to Management Center > Claim RulesScreen_Shot_2021-05-21_at_3.37.05_PM.png
  2. Click "Create Claim Form Rule".
  3. Select the Practice.
    mceclip2.png
  4. Name the claim rule.
    Screen_Shot_2021-05-23_at_6.22.39_PM.png
  5. Set Claim Type to Institutional or Professional depending upon service.
    mceclip1.png  Screen_Shot_2021-05-19_at_12.54.10_PM.png
  6. Set conditions for the claim rule to be met.
  7. Select the Available Behavior: Billing Provider - Address.Screen_Shot_2021-05-21_at_3.32.37_PM.png
  8. Then click Add.
    Screen_Shot_2021-05-19_at_1.15.03_PM.png
  9. From the Select dropdown arrow, choose PracticeBilling Provider Address.Screen_Shot_2021-05-23_at_6.23.01_PM.png
  10. At the bottom of the window, click the Create button.
    Screen_Shot_2021-05-19_at_1.16.07_PM.png

Related Articles

To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.

To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.

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