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Back  RFI # 1879: Billing Provider Addr 2010AA

Formal vs. Informal Help Informal Formal

Submitter

Meredith Haddock

Description

1) If a billing provider moves to a new office at the beginning of the month on 11/12013 and does back billing and submits 837I claims on 11/15/13 for services rendered at the previous billing provider location from 10/01/2013. Which billing provider address (2010AA-N3/N4) should be submitted on the 10/01/2013 claim, the new (current) billing provider address or the previous billing provider address where the 10/01/2013 services were actually rendered for that same billing provider?
2) What is the intent/purpose of the Billing Provider Address N3/N4 segments?
3) Is there supposed to be any true linkage between the 837 Billing Provider Address N3/N4 to any other EDI transactions, primarily the 835 Remittance and that it should be the same?

Submitter Assigned Keywords

billing provider 2010AA N3 address billing provider address N301

Response

The intent and purpose of the Billing Provider Name and Address segments is to provide information related to whom and where the payment of the claim is to be directed by the payer. If the address for the payment is different than that reported in the Billing Provider loop, then the Pay to Address Name loop is required. In the scenario you describe if the new office location is where the payment is to be directed that is the name and address that must be reported as the Billing Provider. If the location where the services were rendered is different than that reported in the Billing Provider loop, then the Service Facility Location Name loop is required to report that location.

There is no direct linkage between Billing Provider Address in the 837 and any other transaction, including the 835, and no technical requirement that the address, if reported in the 835, is the same as that reported as the Billing Provider Address in the 837.
Submission 11/14/2013
Status Date 12/20/2013
Status F - Final
Primary References
Document 005010X223
SectionTable 2
Page87
Set ID837
Table2
Loop2010AA
Segment Position0250
Segment IDN3
Element Position01
Industry NameBilling Provider Address Line