What information is entered into item 33 of the CMS 1500?

33 Required Billing Provider Info & Phone # (Pay-To) – Enter the provider name. Enter the provider address, without a comma between the city and state, and a nine-digit zip code, without a hyphen. Enter the telephone number. 33a Required Billing Provider Info & Phone # (Pay-To, NPI) – Enter the billing provider’s NPI.

What goes in box 32b on a HCFA?

Box 32b is used to indicate the non-NPI identification number of the service facility as assigned by the payer for the facility. Enter the 2-digit qualifier followed by the ID number.

What goes in box 33b on HCFA?

Billing Provider Non-NPI ID
Box 33b Billing Provider Non-NPI ID and qualifier Box 33b contains the non-NPI identity of the Billing provider. The source for the actual non-NPI value is the text entered into the field labeled ‘Box 33B:’ under the ‘HCFA-1500/UB-92’ tab of the Payers screen (of the payer to whom this claim is being sent).

What is box 17a on CMS-1500?

Item 17a – Enter the ID qualifier 1G, followed by the CMS assigned UPIN of the referring/ordering physician listed in item 17. The UPIN may be reported on the Form CMS-1500 until May 22, 2007, and MUST be reported if an NPI is not available.

What is a qualifier 431?

Definition. 431. Onset of current symptoms or illness.

Does CMS-1500 require Box 32?

If a Provider does not have a group NPI number, the national standard for EDI claims is that Box 32 is not necessary as it is already displayed in Box 33. Normally for claims standards, there are two sets of rules; one that applies to printed HCFA claims and a second set of standards that apply to EDI claims.

What is Box 31 on HCFA?

• Enter the rendering provider’s name and date. − Provider should be registered with AHCCCS under the NPI submitted in 24J. − May be an individual provider or the group agency.

What is Box 30 on HCFA?

What is it? Box 30 used to report Balance Due. This field has since been eliminated.

What is Box 33b?

What is it? Box 33b is used to indicate a payer-assigned identifier of the Billing Provider. Some payers require the provider’s taxonomy code be listed in Box 33b.

What is box 33 on the billing form 33?

�� This box is only required when clinics or group practices use a specific billing provider number in box 33. This identifies who rendered the service. �� Shaded – Enter the six (6)-or nine (9)- digit DHS provider number of the individual rendering the service.

What is box 32 on a HCFA?

Besides, what is Box 32 on a HCFA? Box 32 is used to indicate the name and address of the facility where services were rendered. Enter the name, address, city, state, and ZIP code of the location. Note: If Box 32 has the exact same information as Box 33, the clearinghouse will remove that from the EDI file.

How to fill box 33 on CMS 1500?

How to fill box 33 on CMS 1500 BlockNo. Block Name Block Code Notes 33 Billing Provider Info & Ph.# A/A& M/M Enter the billing provider’s name, addre 33a A Enter the 10-digit NPI number of the bil 33b M/A Enter the 13-digit Group/Billing Provide

How do I fill out a 33A form?

Item 33 – Enter the provider of service/supplier’s billing name, address, ZIP Code, and telephone number. This is a required field. Item 33a Form CMS-1500 (08-05) – Effective May 23, 2007, and later, you MUST enter the NPI of the billing provider or group.

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