Which block contains the billing provider's name, address, ZIP, and telephone number?

Which block contains the billing provider's name, address, ZIP, and telephone number?

• A. Block 32
• B. Block 34
• C. Block 31
• D. Block 33

Answer: (D)

Block 33 is where the Billing Provider information is entered. This block is designated for the submitting entity’s contact details, so it includes the billing provider’s name, street address, ZIP code, and telephone number all in one place. Having these specifics together ensures the payer can identify who is submitting the claim and can reach them if there are questions or need for clarification. Other blocks on the form are used for patient/insured data, service facility details, and other information, but they do not collect the complete billing provider contact information.

Block 33 is where the Billing Provider information is entered. This block is designated for the submitting entity’s contact details, so it includes the billing provider’s name, street address, ZIP code, and telephone number all in one place. Having these specifics together ensures the payer can identify who is submitting the claim and can reach them if there are questions or need for clarification. Other blocks on the form are used for patient/insured data, service facility details, and other information, but they do not collect the complete billing provider contact information.