Below is updated information for submitting Ambulance Information onNon-837 (ANSI 5010 Upload) claims. Note that whenever available (inOLE/PM) the actual fields should be used instead of these'workarounds'.
Ambulance Pick Up Location information can be submitted in Box 32. Itwould be output in Loop 2310E Ambulance Pick-Up Location when OfficeAlly transmits to the payer in 5010.
Ambulance Drop Off Location information can be submitted in either Box19 or Line Notes (any line), but MUST be in the format below to berecognized by the system and moved into the appropriate databasefield. It would be output in Loop 2310F Ambulance Drop-Off Locationwhen Office Ally transmits to the payer in 5010.
AMBD;NAME;ADDRESS1;ADDRESS2;CITY;STATE;ZIP
A ; (semi-colon) must be used between each piece of data.
AMBD - This code on the front of the note lets our system know that the information to follow is the Ambulance Drop Off information
NAME - Name of the Drop Off Location
ADDRESS1 - Street Address of the Drop Off Location (Required for thisLoop)
ADDRESS2 - Additional Address of the Drop Off Location (e.g. Suite #,etc...)
CITY - City of the Drop Off Location (Required for this Loop)
STATE - State Code of the Drop Off Location (Required for this Loop)
ZIP - Zip Code of the Drop Off Location (Required for this Loop)
EXAMPLES:
AMBD;VANCOUVER GENERAL HOSPITAL;12345 TEST STREET;SUITE2;VANCOUVER;WA;99999 (All elements included)
AMBD;VANCOUVER GENERAL HOSPITAL;12345 TEST STREET; ;VANCOUVER;WA;99999(If there is no Address 2 data, that there is still a ; listed withnothing in that spot)
AMBD; ;321 HOME STREET; ;VANCOUVER;WA;99999 (The Name is not required,as the Drop Off location could a non-Facility such as a patient'shome)