Claim Forms: Billing Provider - Box 25 and 33

The Billing Provider is used to indicate the name and address of the provider that is requesting to be paid for the services rendered on an insurance claim. Details for billing providers can be managed in your account settings, or directly on a claim form.  

Add a Billing Provider to your Account 

Billing Providers can be added directly to the claim form, or managed in Settings > Insurance > Billing Providers

For your convenience and to reduce claim errors, we recommend that your add your billing provider(s) to your insurance settings, as part of setting up your account for insurance. 

From your insurance settings you can add, edit, or remove billing providers. Once added to your settings, you'll be able to select your preferred billing provider while completing a claim form. 

In the same settings area, you can also choose to make one of your billing providers the default billing provider for your account. By default, all insurance claims will automatically populate with the default billing provider information, which can be changed/edited when completing a claim. 

Billing Provider Details

Information that is requested for Billing Provider includes: 

• Name 
• Phone Number 
• Billing Provider NPI number (this is where an NPI 2 can be added or another individual NPI number)
• Tax ID Type (SSN or EIN) 
• Tax ID Number (SSN or EIN Number) 
• Other ID Qualifier & ID (Other ID Qualifier is an optional field that is used when you need to input another ID, if you do not use an NPI number in your work) 

Add Billing Provider to a Claim Form

In Healthie, there is a Billing Provider section in the claim form. From the drop-down, you can select one of you pre-created billing providers, or choose to add a new provider. 

If you select an existing billing provider, the providers information will auto-fill into the form. You'll still be able to edit any fields. 

Use Individual NPI Instead of Billing Providers to have the rendering (individual) provider NPI number listed instead of the billing provider. For example, if the individual practitioner wanted to be reimbursed for the claim, instead of the group practice.

On the CMS 1500 claim form, the billing provider name, address, and phone number from Healthie will populate in Box 33. You can add the Type 2/NPI 2 or Organizational NPI that appears in Box 33 by going to Organization > Settings. If you have a solo provider account, you can navigate to Settings icon > Organization.

The billing provider NPI number will populate Box 33a. 

The billing provider qualifier will populate Box 33b (if it was provided as anOther ID and Other ID Qualifier)

The billing provider tax ID number will populate Box 25 on the claim form.