Clean claims

To ensure prompt payment, it is important to fill out your claim completely and accurately. The most common claim form used by our providers is the CMS-1500 form. Here are some pointers on submitting a clean claim.

• Box 25 - Federal Tax ID Number

  a. Ensure an appropriate box is checked to indicate if a NPI or SSN is being reported.

• Box 32 - Service Facility Location Information

  a. Providers are required to report the most appropriate place of service on claim submissions. To ensure proper processing and reimbursement for your claims, please make sure you are accurately entering the appropriate place of service (POS) address for all claims submitted. Do not include mail codes.
  
  b. Box 32 may be blank if it is the same as Box 33.
  
  c. Enter place of service addresses in alignment with USPS address format.
  
  d. When submitting multiple claims for a specific practice location, be sure to enter the address consistently across all claims.

• Box 33 - Billing Provider Info & PH#

  a. When a P.O. Box is entered in Box 33, there must also be a physical address in Box 32.
  
  b. P.O. Box is not accepted in Box 33 on paper claims.
  
  c. Enter addresses in alignment with USPS address format.
  
  d. When submitting multiple claims for a specific billing provider, be sure to enter the address consistently across all claims.
  
  e. Must be a single pay-to address for each unique combination of NPI and TIN.

• Box 33a - NPI#

  a. If 33a is a group NPI, the TIN and NPI must match the organization.