Description
This quick guide demonstrates how to fix an invalid claim that indicates a missing provider zip code.
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
Section 1 - Understanding the Provider Zip Code
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An invalid claim response may indicate a missing provider zip code.
- A dentist may be practicing under a single location, or multiple locations. If the provider is billing under a single location, the zip code fields are in the user profile.
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Click the More menu in the top right corner of the Sidekick.
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Select Administration from the menu.
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Select User management from the Administration menu.
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Click User directory.
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A list of all the users opens. Find the dentist attached to the production on the claim.
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Click the More options menu at the right of the provider's name.
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Select view profile from the menu.
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This opens the Dentist information page. The provider zip code is in the claims section.
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There are two options that must be considered for the provider zip code: the render services section and the billing section.
Section 2 - Provider Zip Code for Render Services Address
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The render service address indicates where the procedures were performed.
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The render service address shows in box 56 of the claim form.
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The claim requires a 9-digit zip code.
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This will need to be entered in the render service address in the provider's profile.
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Click edit in the upper right corner of this section.
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If the provider bills from a single location, the services should indicate they are rendered by address.
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Enter a 9-digit zip code in the zip code field as required for the claim.
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Click save to save the changes and close this window.
- The claim will need to be resent after the required information is corrected. For instructions, see Managing Invalid Claims.
Section 3 - Provider Zip Code for Billing Address
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The zip code in the billing address section might need to be corrected as well.
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The billing address indicates where the insurance carrier should send the payment. It shows in box 48 on the claim form.
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The claim requires a 9-digit zip code for the billing dentist.
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Click edit in the upper right corner of the billing address section of the Dentist profile.
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The Edit billing window opens. Click the billing as field.
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Select self if the insurance should pay the remittance to the address listed in this window.
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The zip code must be 9 digits for the claim form.
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Click save when finished.
Section 4 - Clinic Zip Code for Multiple Locations
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If there are multiple clinics and the provider practices in more than one location, the render service section should be set to associated clinic.
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In the Administration menu, click Practice information.
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Click Practice settings and select the clinic.
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Click on the More options menu for the selected clinic and select edit.
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Verify the 9-digit zip code in the clinic details and click save.
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