Form Locator 1 requires which data element?

• A. Patient Control Number
• B. Pay-to name and address
• C. Provider name and address
• D. Type of Bill

Answer: (C)

Form Locator 1 holds the Patient Control Number. This is a unique identifier assigned by the hospital to track the claim within its own systems and to link the claim to the patient’s encounters and subsequent submissions. It travels with the claim through processing and resubmissions, helping the payer and provider keep the record tied to the correct patient and episode of care. The other data items mentioned—Pay-to name and address, Provider name and address, and Type of Bill—are captured in different form locators and serve separate purposes (where payments go, who the billing provider is, and the claim’s billing type), so they belong in other parts of the form rather than the first locator.