Which element is situational for the Pay-To information on UB-04?

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

Answer: (B)

Pay-To information on UB-04 is used only when payments should be sent to a different entity than the billing provider. You would fill in the pay-to name and address only if there’s a separate pay-to arrangement (for example, a centralized billing service or third-party administrator). If there isn’t such an arrangement, those fields are not needed and are left blank.

Medical Record Number is simply the patient's internal identifier used by the hospital and has nothing to do with directing payments. Type of Bill indicates the category of claim (inpatient, outpatient, etc.) and is a standard field always used to identify the claim type. Patient Control Number is an internal tracking number for the provider’s records and does not pertain to payment routing.