Office Ally | PO Box 872020 | Vancouver, WA 98687
Office Ally offers the ability for Providers to Register Physical Address Information with Office Ally in order to meet
5010 requirement for CMS1500 Box 33 Billing Provider Address.
With the implementation of the 5010 format, PO or Lock Box addresses are no longer allowed in the Billing Provider
loop (CMS1500 Box 33).
DOES THIS AFFECT YOU?
If you are not sure whether this affects you, check what address you are currently sending Office Ally in Box 33 of the
- If you are sending a physical address in Box 33, this notice does not affect you.
- If you are sending a PO Box address in Box 33, this notice is for you.
I AM SENDING A PO BOX IN BOX 33, WHAT DOES THIS MEAN FOR ME?
Providers who currently send their Pay-To Address (that is a PO Box) in CMS1500 Box 33 could receive claim rejections
from Payers that enforce the 5010 rule that PO Boxes are not allowed in the Billing Provider loop.
WHAT CAN I DO?
Office Ally has set up the ability for providers to register their Physical Address (by Billing NPI) with Office Ally.
To take advantage of this new ability, providers can fax/email an authorization letter to Office Ally; it must be on the
Provider/Practice letterhead and contain:
- Billing Provider NPI the request is in reference to
- Physical Address to be registered under the Billing Provider NPI above (make sure to include the full 9 digit zip
code, which is another possible requirement under the 5010 format)
ording authorizing Office Ally to register the physical address under the Billing Provider NPI provided, so that,
for claims that have a PO Box address sent in CMS1500 Box 33, Office Ally will copy that PO Box address to the
o Provider loop and populate the registered physical address into CMS1500 Box 33 (Billing Provider Loop)
ffice Ally Username
- Email address that a confirmation can be sent to once registration complete
- Signature of the Provider/Owner of the practice with name and title listed
A template letter that can be filled out electronically, and then printed on your letterhead, can be found on the last
he letter can be faxed to Office Ally at (360) 896-
or emailed to email@example.com
NOTE: Emailed letters MUST be scanned letters that contain actual signatures.
PHYSICAL ADDRESS REGISTRATION LETTER
INSTRUCTIONS AND TEMPLATE