Which Form Locator corresponds to Payer Identification (Name) and is required on the UB-04 form?

• A. Form Locator 50 - Payer Identification (Name) - Required
• B. Form Locator 51 - Health Plan Identification Number - Situational
• C. Form Locator 52 - Release of Info Certification - Required
• D. Form Locator 53 - Assignment of Benefit Certification - Required

Answer: (A)

The key idea is that UB-04 must clearly identify who is paying the claim, so the payer’s name is captured in a field specifically for Payer Identification (Name) and that field is required. This ensures the claim is routed to the correct payer and can be processed and adjudicated properly. The other fields serve different purposes and are not always present: the Health Plan Identification Number identifies a specific plan and is situational, Release of Information Certification is needed only if the patient authorizes release of their information, and Assignment of Benefits Certification is needed only when the patient assigns benefits. So the Payer Identification (Name) field is the one that must be completed on every UB-04 submission.