Box 33 - Physician's, Supplier's Billing Name, Address, Zip Code & Phone
Box33 contains the Physician's or Suppliers Billing Name, Address, Zip Code, & Phone Number (the first three lines of Box33) In addition, the bottom of the Box33 (the fourth line) optionally contains the PIN# and/or GRP#. The last two items are described in Box33 - PIN# and Box33 GRP# respectfully.
Notes:
- In 99% of all cases, the Name, Address, City, State, Zip and Phone # are taken directly from the Company Setup screen. Their is an exception to this, but due to software licensing considerations, you must call technical support to discuss your alternatives.
- The font used on the HCFA-1500 is called Courier which a "fixed width" font. This font is required on HCFA-1500 claim forms and is of the size of 10 characters per inch. The reason for stating this fact is that the size of the font strictly limits the number of characters that can appear in any specific box on the claim form. For example, the maximum number of characters that can appear is 28.
- The first line will contain the Operating Name contained in the Company Setup screen.
- The second line will contain the Address contained in the Company Setup screen.
- The third line will contain the City, State, and Zip contained in the Company Setup Screen. Optionally, the third line will contain the Phone # contained in the Company Setup screen provided the total length of the City, State, Zip, AND Phone # will actually fit within 28 characters. Obviously, long city, state, and zip names such as 'SAN FRANSISCO CA 98765 (23 characters including the trailing space) with a standard phone number (12 digits) both add up to 35 characters. In this case, it is simply impossible to include the phone # and therefore DELPHI32 will automatically drop it. If you REQUIRE the phone number, you will have to place it in Box33 - PIN# or Box33 - GRP#.
- When required, the fourth line allows you to enter Box33 - PIN# and Box33 - GRP# which are described in their own sections.