HIPAA 5010 Compliance – Loop 2010AA Billing Provider Address
Posted 07/13/12; Modified 07/26/12

Effective June 30, 2012, all health plans, claims clearing houses, and healthcare providers are required to follow HIPAA 5010 standards for claims processing. HealthChoice, the Department of Corrections (DOC), and the Department of Rehabilitation Services (DRS) are compliant with 5010 standards.

According to HIPAA 5010, a Loop 2010AA Billing Provider Address must not contain the following exact phrases: “Post Office Box”, “P.O. BOX”, “PO BOX”, “LOCK BOX”, “LOCK BIN” or “P O BOX”. The Loop 2010AA Billing Provider Address must be a physical address. This rule applies to dental, professional, and institutional claims.

For claims processed on or after November 1, 2012, Emdeon, the clearinghouse utilized by HP Administrative Services, LLC (HP), the claims administrator for HealthChoice, DRS, and DOC, will apply the edit which denies claims containing the phrases mentioned above.

We encourage you to make every effort to confirm that the correct addresses are captured and inserted in the correct locations on your claim submissions. If you have any questions, please contact HP Administrative Services, LLC at 1-405-416-1800 or toll-free 1-800-782-5218.