The Provider Information will be used for the Billing Provider and the Practice Information will be ignored, except for the Pay-To tab.

Lists->Provider->Providers

Select and Edit a Provider

The individual provider's Address Tab will be used as the Billing Provider Information.  Since this provider uses a Pay-To address this address will need to be the physical location of the Provider/Practice.

(Box 33 on a Paper Claim (may differ because Box 33 address will be Pay-To on paper claims) or Loop-2010AA in ANSI)

The individual's NPI and TaxID/SSN will be entered under Lists->Provider->Providers->Provider IDs Tab

(note: you should only have one 'All-All-All' filter rule, delete any duplicates lines or unneeded filters)

(This NPI will appear in both box 24j and box 33a on a paper claim or will only appear as Loop-2010AA in ANSI as Loop2310B will not be sent because the Billing Provider is assumed to be the Rendering Provider)

Make sure 'File Claim As: Individual' is set when you Edit the Provider IDs

The Practice Information Pay-To Tab should be filled out with the Pay-To Address.