Get Hipaa 5010 Update Form - Horizon Nj Health

The HIPAA 5010 Update Form for Horizon NJ Health is essential for ensuring that your billing address is accurately recorded. This guide will help you navigate the process of filling out the form online, step by step, to facilitate smooth processing of your claims.

Follow the steps to accurately complete the form.

1. Press the ‘Get Form’ button to obtain the document and open it in your preferred editing interface.
2. Enter the date at the top of the form in the designated field. This date denotes when you are completing the update.
3. Fill in the 'Provider Name' section with your full name or the name of the practice as recognized by Horizon NJ Health.
4. Indicate your specialty in the corresponding field, ensuring it aligns with your registered qualifications.
5. Input your Provider ID number, which is essential for identification within the Horizon NJ Health system.
6. Provide your Tax Identification Number (TIN) accurately in the specified box for billing verification.
7. Complete the 'Service Address' field with your actual billing address, ensuring that it is a physical street address, as P.O. Boxes are not acceptable.
8. Enter your contact phone number so that Horizon NJ Health can reach you if there are any questions regarding your form.
9. For the 'Billing Address,' ensure it reflects your physical billing address, avoiding the use of P.O. Boxes once again.
10. Specify your remit address for payments and explanation of benefits (EOBs) and ensure it is consistent with your billing address.
11. Provide the name and telephone number of the individual completing the form for any follow-up communications.
12. After completing all fields, review the form for accuracy before saving your changes, downloading, printing, or sharing the document as necessary.

Complete your form online today to ensure accurate and timely processing of your claims.