Use Facility or Practice Address as Billing Provider Address

This rule will instruct the system to use the Facility or Practice Address as the billing provider address. 

Workflow

Let's review how to create a claim rule to use the Facility or Practice Address as the billing provider address!

• 1. Navigate to Management Center > Claim Rules.
     
     
  2. Click Create Claim Form  Rule.
     
  3. Select the Practice.
     
  4. Next, give the rule a name.
  5. Update the Claim Type to Institutional or Professional.
     
  6. Select Conditions to create criteria a claim should meet before the rule will apply.
     
  7. Next, click on the Behaviors dropdown.
  8. Select Billing Provider - Address
     
     
  9. Next, click Add.
     
  10. To use the Facility Address, update the dropdown to Facility Address.
      
  11. To use the Practice Address, select Practice Billing Provider Address.
      
  12. To create multiple behaviors, repeat steps 7-10.
  13. Click Save to complete the process.
       

Box Number(s)

• UB-04: Box 1- Billing Address, Phone, and Provider. 
• CMS-1500: Box 33- Billing Provider Information

Helpful Hints

• If one of your conditions is payer-based, select Current Sequence Behavioral instead of the Primary Behavioral Payer. This will ensure the rule applies to secondary and tertiary claims when needed. 
• 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.