What is it?
Box 33 is used to indicate the name and address of the Billing Provider that is requesting to be paid for the services rendered. Enter the name, address, city, state, and ZIP code. P.O. Boxes are not allowed for electronic claims. Enter the information in the following format:
- City, State, and ZIP Code
- If the NPI is listed as an Organization/EIN, the Business name will be used.
- If the NPI is listed as an Individual/SSN, the First and Last name will be used.
By default, the system uses the information found under Admin > Member Info to populate Box 33.
For a specific payer, please see: Box 33: Insurance Specific Billing Provider.
For a group, please see: Provider Groups
Loop 2000AA, Segment NM103 (Last Name or Organization Name), NM104 (First Name), NM105 (Middle Name/Initial), NM107 (Suffix), N301 (Street Address), N302 (Street Address 2), N401 (City), N402 (State), N403 (ZIP Code), PER04 (Phone Number).