PO Box change for mental health billing?

[abarron]

Does anyone know where I can find documentation on the PO box rules that are changing January 1st?  Apparently PO boxes will no longer be allowed for receiving payments?  I have a provider that has a physical office but cannot securely receive mail there so has a PO Box for payments.  Not sure of her options now?  She doesn't want the payments going to her home address.  Can anyone help with this issue?  Thank you!

[PMRNC]

This has been a requirement of HIPAA 5010 since it began and as of 1/1/2012 providers will have to have a physical address.. not much she can do except comply.

[abarron]

Thanks...I was reading on the internet that a way around it is that the PO box could be placed in the "Pay To" field as long as the physical address is in the billing provider info field.  However, I don't really know of a "Pay to" field on the claim form.  Do you know anything about this?

[PMRNC]

There is no work around because it's not a matter of the "field" it's the matter that they are NOT accepting PO Boxes period..MUST be a physical address. I think one of reasons is probably to regulate providers to be sure they are in full compliance.

[MFunk]

I was reading in the new Advanced  Marketing book about this PO Box issue. So I was trying to find information. Via website. Also calling my vendor and then finally Medicare Highmark. When we filled out our enrollment application we had to have a physical address. That was 2004. Our provider didn't want her payments to go there. So she has a PO box for her pay to adress.  My vender said that is fine. Our medical billing software has the tabs for Pay to and billing provider. So when it goes electronically both transmit. After speaking with Medicare today. I was told this was fine. Nothing would change.

[PMRNC]

You are receiving false or mis understood information.   Indeed there MUST be a valid physical address with 9 digit zip code format for all HIPAA 5010 claim transactions.   While the PAY To address (used for payments and remittances) can be a PO box.  This is part of HIPAA 5010 NATIONAL changes. Carriers are NOT getting to pick/choose which formats are accepted, this is done on the national level.   Here is info right from Highmark's website.

https://www.highmark.com/edi/news/hipaa/2011/avoidErrors-051611.shtml

[PMRNC]

Also there are no separate compliance regulations in regards to claim transactions for mental health providers or any other specialty, just wanted to add that in due to the subject field. ALL providers must be in compliance.

[MFunk]

Wow! Loving the fast response. I'm new here. Plus I was looking everywhere for that PO box documentation.  "I think I'm gonna like it here!!"

[PMRNC]

I did a little of my own digging because I do mental health too and many MH provider's don't want their address sent.. USUALLY when you credential most of the carriers require an actual physical address anyway, and even though it's required for 2010 transactions, the carriers will still send payments and remittances to the address they have on file, with that in mind, I'm pretty sure patient's won't see the physical address at all and that would be the only thing providers would need to be concerned with.. but again, they had to provide a physical address for credentialing purposes, so this really shouldn't be a big deal.