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Box 5

Patient’s Address

What’s in the box?

This box contains the patient’s full address and phone number.

Where does this info live in Jane?

The patient’s address and phone number are set within the Patient Profile. To adjust this information, head to their profile and click Edit/Settings.

Note:

  • Both Street Address lines 1 and 2 will be included in claim submissions.
  • The patient’s Mobile Phone number is used for claim submissions.

Is this required?

The patient’s Street Address line 1, City, State, and Zip Code are required on the CMS1500. Street address line 2 and Mobile Phone are optional.

The patient’s Atreet Address line 1, City, State, and Zip Code are required when billing via EDI file. Street address line 2 is optional, and the Mobile Number is not included in the EDI file.


What about the EDI file?

Although the patient’s address is always required, where this information is sent in the EDI is situational.

Option 1: Patient is the Subscriber

If the patient is also the Subscriber (the patient is the one who holds the insurance policy), then Loop 2000C - Patient is not sent in the EDI. Thus, the patient street address is sent in Loop 2000B - Subscriber.

  • The patient’s street address line 1 is sent in Loop 2010BA - Subscriber Info, Segment N301
  • The patient’s street address line 2 is sent in Loop 2010BA - Subscriber Info, Segment N302
  • The patient’s City is sent in Loop 2010BA - Subscriber Info, Segment N401
  • The patient’s State is sent in Loop 2010BA - Subscriber Info, Segment N402
  • The patient’s Zip Code is sent in Loop 2010BA - Subscriber Info, Segment N403

Option 2: Patient is not the Subscriber

If the patient is not the subscriber (i.e. their spouse is the Policyholder and they are covered under that policy), then the patient’s street address is sent in Loop 2000C - Patient.

  • The patient’s street address line 1 is sent in Loop 2010CA - Patient Info, Segment N301
  • The patient’s street address line 2 is sent in Loop 2010CA - Patient Info, Segment N302
  • The patient’s City is sent in Loop 2010CA - Patient Info, Segment N401
  • The patient’s State is sent in Loop 2010CA - Patient Info, Segment N402
  • The patient’s Zip Code is sent in Loop 2010CA - Patient Info, Segment N403

Note: The patient’s Mobile Phone number is not included in the EDI in either scenario.