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Box 7

  1. US Insurance Billing Additional Resources
  2. Box 7

    3. 3 min read

Member/Insured’s Address

What’s in the box?

This box indicates the address and phone number of the Insured (the Policyholder).

Where does this info live in Jane?

This depends on whether the patient is the Insured or not. This can be found by heading to the Patient Profile> Billing> Insurance policies and clicking View on an existing Policy or creating a New Insurance Policy. Under the Insured’s Info heading, you can use the drop-down menu to set the Patient Relationship to Insured.

If the Patient is the Insured: set Patient Relationship to ‘Self’

If the Policy is set to Self, then Jane will use the address and phone number entered in the Patient’s Profile. To adjust the patient’s address, head to their Profile and click Edit/Settings.

Note:

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

If the Patient is not the Insured: set Patient Relationship to the appropriate status

If the Patient Relationship to Insured is set to something other than Self, then the address of the Insured can be added directly to the Policy, under the Insured’s Info heading.

Is this required?

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

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

What about the EDI file?

The Insured’s street address is sent in Loop 2000B - Subscriber.

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

Note:

  • In Jane, there is only an option to include a second address line if the patient is the Subscriber.
  • The patient’s Phone number is not included in the EDI.
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