5010 Physical Address Requirement

How can I ensure payments continue to go to a PO Box instead of the physical location?

PO Boxes are not permitted in the Billing Provider address field in 5010 claim transactions. If you have a PO Box address set up in the Submitter Types Master Files, you will need to use the following settings when sending 4010 (Legacy) and 5010 (Standard) claims to ensure claims are not denied and that payments go to the correct PO Box address instead of the physical address.

1. Go to Master Files | Submitter Types.
2. Select the electronic submitter for Group and/or Provider.
3. Enter the PO Box in the Address field.
4. Enter 9-digit Zip Code.
5. Un-check Box 33 Name and Box 33 Addrs.
6. Set the Use As field to PAY TO VALUES.
7. Click Save.

This will make the system generate a Pay To loop in the claim file containing the PO Box as the Pay To address in 4010 (Legacy) electronic claims.

8. Go to Master Files | Providers/Groups | Groups and/or Providers.
9. Select a Group or Provider.
10. Enter the Physical Address in the Address field.
11. Click Save.

This is where the system will pull the Billing Provider loop information for 4010 (Legacy) and 5010 (Standard) electronic claims.

12. Go to Master Files | Providers/Groups | Providers.
13. Select a Provider.
14. Click the Pay To Addr button.
15. Enter the PO Box in the Address field.
16. Enter 9-digit Zip code.
17. Click Save.

This will make the system generate a Pay To loop in the claim file containing the PO Box as the Pay To address in 5010 (Standard) electronic claims. If this screen is not completed, the system will generate the Pay To loop using the address from the Submitter Types Master File.

**Only demonstration information was used to create this post**

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