Which Form Locator is Insured's Name and Required?

• A. Form Locator 58 - Insured's Name - Required
• B. Form Locator 50 - Payer Identification
• C. Form Locator 57 - Other Providers ID
• D. Form Locator 59 - Patient's Relation to Insured

Answer: (A)

The insured's name is entered in the field labeled Insured's Name on the UB-04 claim. This field is required whenever there is an insured on the policy because it helps the payer correctly identify the member tied to the policy, verify eligibility, and attach the claim to the right coverage. The other options refer to different data elements: Payer Identification identifies the payer, Other Providers ID is a separate provider ID, and Patient's Relation to Insured indicates how the patient is related to the insured, not the insured’s name. If there is no insured, this field is typically left blank, and the claim proceeds with the applicable coverage information.