Section title: Requests for Interpretation
RFI #
1522
837P - 2010AB Pay-to Address
Description

The 5010 2010AB NM1 elements are marked as not used except for NM101 and NM102. When the Pay to Provider name is different than the billing Provider in 2010AA. where does the name for the Pay to provider go? How can a Pay to provider cash a check when it's made out to somebody else?

RFI Response

The purpose of this Loop has changed from previous versions. It now only contains address information when different from the Billing Provider's primary business address reported in the 2010AA loop, allowing for an address to direct the payment. Payers will consider the Billing Provider Name submitted, information on the payer's files, and contractual arrangements to determine who to pay and how to make that payment. Note that sections 1.10.3 and 1.10.4 of the TR3 explain that when an organizational health care provider enumerates its subparts, those subparts must be reported as the Billing Provider.

DOCUMENT ID
00501x22A1