Fixing an Invalid Claim for Missing Provider Zip Code

---

Description
This quick guide outlines how to fix an claim with the invalid message of 'invalid provider zip code'.

Contents

The Provider Zip Code May Need to be Corrected in One or More of the Following Sections:

• Section 1 - Understanding the Provider Zip Code
• Section 2 - Provider Zip Code for Render Services Address
• Section 3 - Provider Zip Code for Billing Address
• Section 4 - Clinic Zip Code for Multiple Locations

---

Steps

Section 1 - Understanding the Provider Zip Code

1.  An Invalid Claim Response May Indicate a Missing Provider Zip Code

   

2. A Dentist May be Practicing Under a Single Location, or Multiple Locations. If the Provider Billing under a Single Location, the Zip Code Fields are in the User Profile.

3. Click the More Menu in the Top Right Corner of the Sidekick

   

4. Select Administration from the Menu

   

5. Select User Management from the Administration Menu.

   

6. Click User Directory

   

7. A List of all the Users Opens. Find the Dentist Attached to the Production on the Claim.

   

8. Click the More Options Menu at the Right of the Provider's Name.

   

9. Select View Profile from the Menu.

   

10. This Opens the Dentist Information Page. The Provider Zip Code is in the Claims Section.

    

11. There are Two Options that must be Considered for the Provider Zip Code, in the Render Services Section and the Billing Section.

    

---

Section 2 - Provider Zip Code for Render Services Address

1. The Render Service Address indicates where the Procedures were Performed.

   

2. The Render Service Address shows in Box 56 of the Claim Form.

   

3. The Claim Requires a 9 Digit Zip Code.

   

4. This will Need to be Entered in the Render Service address in the Providers Profile.

   

5. Click Edit in the Upper Right Corner of this Section.

   

6. If the Provider Bills from a Single Location, the Services Should Indicate they are Rendered by Address.

   

7. Enter a 9 Digit Zip Code in the Zip Code Field.

   

8. Click Save to Save the Changes and Close this Window.

   

9. The Claim will Need to be Resent after the Required Information is Corrected. For Instructions on How to do this, See Managing Invalid Claims.

---

Section 3 - Provider Zip Code for Billing Address

1. The Zip Code in the Billing Address Section might need to be corrected as well.

   

2. The Billing Address Indicates where the Insurance Carrier Should Send the Payment for the Claim. It shows in Box 48 on the Claim Form.

   

3. The Claim Requires a 9 Digit Zip Code for the Billing Dentist.

   

4. Click Edit in the Upper Right Corner of the Billing Address Section of the Dentist Profile to Correct this.

   

5. The Edit Billing Window Opens. Click the Billing As Field.

   

6. There are a Few Options to Choose From.

   

7. If Self is Selected, this Indicates the Insurance will Pay the Claim Remittance to the Address Listed in this Window, and this Address is Usually the Same Clinic where Procedures were Performed.

   

8. The Zip Code has to be 9 Digits for the Claim Form.

   

9. Click Save when Finished to Save the Changes and Close the Window.

   

10. If the Provider is Billing as a Billing Entity, it Inidicates the Payment will be Sent to a Third Party Billing Company.

    

11. The Claim Form Requires a 9 Digit Zip Code. Enter it in the Zip Code Field.

    

12. The Claim will need to be Resent after the Required Information is Corrected. For Instructions on how to do this, see Managing Invalid Claims.

---

Section 4 - Clinic Zip Code for Multiple Locations

1. If there are Multiple Clinics in a Database, and the Provider Practices in More than One Location, the Render Service Section should be set to Associated Clinic. If the Billing Section is Set to Associated Clinic, it means the Insurance Payments will be Sent to the Clinic where the Production was done.

   

2. If either of these are set to Associated Clinic, it Indicates the Clinic Address in Clinic Settings will be in the Respective Field on the Claim Form.

   

3. In the Administration Menu, click Practice Information.

   

4. Click Practice Settings.

   

5. This opens the Practice Settings. Identify the Clinic from the options.

   

6. Click on the More Options Menu at the Far Right of the Selected Clinic.

   

7. Click Edit from the Menu.

   

8. This Opens the Clinic Details, including the Clinic Address.

   

9. Click Save in the Bottom Right Corner when Finished.

   

10. The Claim will need to be Resent after the Required Information is Corrected. For Instructions on how to do this, see Managing Invalid Claims.