3.2 HCFA 1500

Most of these boxes are uncommon & will not require configuration.

1. Box 33a Can check either Group or Individual NPI to appear as Billing Provider. These codes are pulled from Admin account & as long as client has everything populated correctly in Admin it will appear on claim form.

2. Check Box 33 'Use Facility Name': If they want the Practice name to appear as billing provider & not the doctor's name.

3. Box 11 – Most Insurance Co's will require checkbox 'Use Group Policy Number'

   1. Medicare Specific Requirement: for Box 11 - leave checkbox unchecked & instead enter in Box 11 field the word 'None' This will appear when there is no other insurance primary to Medicare & they require this set-up.

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