Claim Form Rule - Pay-To Address

What claim change is needed?

Add the Pay-To address to the professional claim form.

Box Number

UB-04: n/a

CMS-1500: Box 33 - Billing Provider Info and Ph#

Steps

1. Navigate to Management Center > Claim Rules.
2. Select "Create Claim Form Rule".
3. Select the practice.
   
4. Name the claim rule.
   
5. Set the Claim Type to Professional.
   
6. Set conditions for the claim rule to meet.
7. Under available behaviors, select "Pay-To Address".
   
8. Click "Add".
9. Select "Write to Claim".
   
10. Save.