What it is:
Box 33 is used to indicate the billing provider’s or supplier’s billing name, address, ZIP code, and phone number and is the billing office location and telephone number of the provider or supplier. Enter the provider’s or supplier’s billing name, address, ZIP code, and phone number. The phone number is to be entered in the area to the right of the field title. Enter the name and address information in the following format:
- 1st Line – Name
- 2nd Line – Address
- 3rd Line – City, State and ZIP Code
Item 33 identifies the provider that is requesting to be paid for the services rendered and should always be completed.
Do not use punctuation (i.e., commas, periods) or other symbols in the address (e.g., 123 N Main Street 101 instead of 123 N. Main Street, #101). Enter a space between town name and state code; do not include a comma. Report a 9-digit ZIP code, including the hyphen. Do not use a hyphen or space as a
separator within the telephone number.
5010A1 requires the “Billing Provider Address” be a street address or physical location. The NUCC recommends that the same requirements be applied here.
Therabill will use a number of fields from the Edit member information dialog to populate box 32. The Phone field is used to populate the phone number area. The Organization name or First name + Last name field(s) are used to populate line 1. The Billing address fields are used to populate line 2. The City, State, and ZIP code fields will be used to populate line 3.
Click on Admin->Member Info to bring up the Member (Billing Provider) Information page. Click on the green Edit button to bring up the Edit member information dialog. Enter your name, address and phone information as needed.
You can over-ride the information that goes out in Box 33 by using Billing Provider Information only to a Specific Payer.